Erysaa (epoetin alfa biosimilar) / PanGen Biotech, CCM Pharma - LARVOL DELTA

Federal PBM Compensation Shifts: Early CAA 2026 Considerations. (PubMed, Am J Manag Care) - "Similar mandates apply under the Employee Retirement Income Security Act of 1974 (ERISA) for employer-sponsored plans, though they are primarily subject to mandatory pass‑through and fiduciary reasonableness standards rather than explicit statutory delinking of service fees...Early evidence suggests that while the CAA 2026 enhances accountability, it may also introduce new distortions in pricing strategies. Managed care organizations will likely need to adapt to a data-intensive, plan-centric model of oversight as these reforms continue to evolve."

Journal

Fertility benefits in graduate medical education: impact of state mandates. (PubMed, BMC Med Educ) - "State mandates improve but do not guarantee complete fertility benefit access for medical trainees. GME programs must proactively address structural gaps through comprehensive benefits, transparent policies, and fertility education to advance trainee wellness, gender equity, and workforce retention."

Journal • Gynecology • Infertility • Sexual Disorders

Unintended access barriers: How upper payment limit implementation may risk patient access. (ASCO 2026) - "We included health insurance exchange (HIX) and commercial plans, recognizing PDAB statutes vary in scope and may not apply to all ERISA-regulated self-funded plans... Patient access to oral oncology drugs in UPL states was often similar to – and sometimes better than – access in non-UPL states. These findings support concerns about future access waning through reduced coverage, adverse tiering, or increased UM, highlighting specific risks by state. For example, commercially- and HIX-insured patients in MD and MN more often have access to the included drugs on preferred tiers than those in non-UPL states; if UPLs were implemented, they may experience higher cost-sharing if plan sponsors placed the drugs on adverse tiers to steer patients towards non-UPL drugs."

Clinical

Variability in Supplemental Breast Imaging Coverage and Cost-Sharing in the Northeastern United States Following 2024-2025 Legislative Actions: A Policy and Payer Implementation Analysis (ACR 2026) - "Overall, state mandates in the Northeast improved protections for supplemental and diagnostic breast imaging, but implementation remained uneven, limiting equitable access. Persistent gaps affecting MRI, Medicare beneficiaries, and ERISA plans disproportionately impact patients with dense breasts and older adults who face higher risk of delayed diagnosis. None"

Challenges to Improving Health Care Delivery Through ERISA Fiduciary Litigation. (PubMed, J Law Med Ethics) - "Commentary on "ERISA and the Failure of Emplloyers to Perform Their Fiduciary Duties: Evidence from a Survey of Health Plan Administrators.""

Journal • Review

Prospect of Fiduciary Duty as a Mitigating Factor for Healthcare Expenses. (PubMed, J Law Med Ethics) - "The evidence provides a data-driven basis to assess whether employers meet their fiduciary obligations, leading to the conclusion that employers need to increase their diligence or face the possibility of significant liability. The increased diligence may also mitigate health care costs."

Journal • Review

PERSPECTIVE: Self-Funded Group Health Plans: A Public Mental Health Threat to Employees? (PubMed, J Ment Health Policy Econ) - "ERISA's judicial review provisions further disadvantage plan participants by requiring courts to defer to employer benefit interpretations and by severely restricting available relief. To improve access to affordable, high quality mental healthcare for participants in self-funded health plans, the following reforms are crucial: a federal definition of medical necessity, time and distance standards for network adequacy, hold harmless provisions for out-of-network costs due to network inadequacy, and removal of restrictions on judicial review and available remedies."

HEOR • Journal • CNS Disorders

ERISA and the Failure of Employers to Perform Their Fiduciary Duties: Evidence from a Survey of Health Plan Administrators. (PubMed, J Law Med Ethics) - "We provide evidence, from a novel survey of respondents who administer or oversee health benefits for their companies, that many employers appear to neglect even the most basic of their fiduciary obligations to their employees. This neglect may help explain the poor performance of employer plans in controlling costs and providing access to health care, and it suggests that many employers may be vulnerable to liability from ERISA lawsuits."

HEOR • Journal

How employers can fight the price crisis. (PubMed, Am J Manag Care) - "Plan sponsors can leverage membership in national and regional health care business coalitions, such as The ERISA Industry Committee and the Employers' Forum of Indiana, for policy advocacy and education at federal and state levels...Although navigating policy advocacy may seem daunting, Catalyst for Payment Reform emphasizes the importance of aligning public policy strategies with procurement/purchasing strategies. By engaging in tailored advocacy efforts, plan sponsors can help lower health care costs, improve access, and ensure sustainable benefits for their plan members."

Journal

Implementation Of New Mexico's 'No Behavioral Health Cost Sharing' Law: A Qualitative Study. (PubMed, Health Aff (Millwood)) - "Engagement strategies were needed to inform eligible members and facilitate enrollment in eligible plans. The law provides a potential model for states to improve access to behavioral health care, but impacts may be limited by factors such as workforce, awareness, and federal ERISA constraints."

Journal

Audit of Mortality Causes and Practices on Children With Heart Diseases at Jakaya Kikwete Institute (SCCM 2024) - "Pediatric mortality audits are accessible indicators of trends in the provision of care in children with heart diseases, early detection of critical congenital heart diseases, infection control and a system of timely recognition of patient clinical deteriorations relies on regular vital signs monitoring for early management escalations in critically ill patients to prevent future adverse events and deaths."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Infectious Disease • Metabolic Disorders • Pediatrics • Respiratory Diseases • Septic Shock

"It was lovely meeting you, Erisa! 😊" (,@bhardwaj_swat)

"Please get angry. Contact state/fed senators & reps, state ins commissioners, file ERISA complaints, etc if your health is being held hostage by your insurance co. #priorauth is out of control & costing lives. @UHC is greedy but, in a race to the bottom, it's in bad company." (,@DrKatePedersen)

Reimbursement • US reimbursement

"The amount of federal law violations from COVID racking up are insane. Too bad no one in the federal government is pursuing $CI DOL violations, ERISA violations, FFCRA violations. I could go on." (,@TakeWeightOffMD)

Novel Coronavirus Disease

"U.S. Department of Labor Appoints Jack Towarnicky, Member of aequum LLC, to ERISA Advisory Council https://t.co/VAKYzkb8x4" (,@NewsFromBW)

N tracing reveals preference for different nitrogen forms of Fusarium oxysporum f. sp. cubense tropical race 4. (PubMed, Front Microbiol) - "Mycelium N abundance increased significantly between the PDA50 + A50/RBM50 + A50 treatments (50% organic nitrogen+50%NHNO) and the PDA10 + A90/RBM10 + A90 treatments (10% organic nitrogen+90%NHNO). These results indicate that the higher C:N ratio reduced mycelium growth by reducing its biomass and diameter and showed that Foc TR4 preferred to use ammonium nitrogen to promote the growth. These findings suggest that treating banana crops with a combination of organic and inorganic (i.e., nitrate) nitrogen could be a better way to defend against Fusarium wilt of banana."

Journal • RBM10

"Further #ERISA limits physicians’ abilities to hold Insurers Accountable." (,@TakeWeightOffMD)

Synthesis and Processing of Dynamic Covalently Crosslinked Polydextran/Carbon Dot Nanocomposite Hydrogels with Tailorable Microstructures and Properties. (PubMed, ACS Biomater Sci Eng) - "The role of PDA with different oxidation degrees (i.e., PDA10, PDA30, and PDA50) in affecting the microstructures and properties of PDA@CD hydrogels was systematically investigated, showing that the PDA50@CD hydrogel presented the densest structure and the highest mechanical strength among the three PDA@CD hydrogels. The pH-responsiveness, 3D printing, electrospinning, and biocompatibility of PDA@CD hydrogels were also demonstrated, showing the great promise of using PDA@CD hydrogels for applications in biomedicine and biofabrication."

Journal

"ERISA. In most circumstances it’s against the law to sue your insurer for damages." (,@BruckelJeffrey)

"She's referring specifically to ERISA plans, where employer self-insures. Fully-insured plans (underwritten by an insurance carrier) are regulated by state DOI. Self-insured plans (usually admin'd by a TPA) are regulated by federal DOL." (,@NathanWilkes)

Reimbursement

"State #FixPriorAuth efforts such as goldcarding don’t address 70% of commercial market governed by ERISA. @fergmd @DoctorJesseMD @DrSandyFryhofer @JackResneckMD @subailey @TomMadejski @RussKridel @lasereyedoc @wvedwards @DoctorJesseMD @PKoiralaMDPhD @DrMichaelSuk" (,@DrAlexUrology)

Ranking and selection of dental restorative composite materials using FAHP-FTOPSIS technique: An application of multi criteria decision making technique. (PubMed, J Mech Behav Biomed Mater) - "The weight criteria of PDAs was evaluated by the FAHP; PDA-1 (0.084, 0.083, 0.083), PDA-2 (0.084, 0.095, 0.102), PDA-3 (0.079, 0.097, 0.110), PDA-4 (0.084, 0.108, 0.124), PDA-5 (0.084, 0.091, 0.093), PDA-6 (0.062, 0.083, 0.113), PDA-7 (0.070, 0.081, 0.098), PDA-8 (0.058, 0.071, 0.090), PDA-9 (0.073, 0.074, 0.092), PDA-10 (0.070, 0.076, 0.089), and PDA-11 (0.157, 0.135, 0.098), respectively. The FTOPSIS is used to determine the rank of alternatives as DHZ4 > DHZ8 > DHZ0 > DHZ6 > DHZ2. The Hybrid FAHP-FTOPSIS technique was significant in ranking analysis of different dental restorative composite materials under conflicting PDAs."

Journal

"2022 Employee Retirement Income Security Act (ERISA) Facts: 900 of Most Common ERISA-Related Questions - https://t.co/guyiBzPH8C https://t.co/SHrOWbzCE2" (,@NewsFromBW)

"Dorsey Launches ERISA Insights Blog https://t.co/1cBG6qeLOn" (,@NewsFromBW)

A multicentre, multi-national, double-blind, randomised, active-controlled, parallel-group clinical study to assess the safety and efficacy of PDA10 (Epoetin-alpha) vs. Eprex® in patients with anaemia of chronic renal failure. (PubMed, BMC Nephrol) - "This study has confirmed the therapeutic equivalence between PDA10 and Eprex® in terms of efficacy, dosage requirement and safety profile in haemodialysis patients with renal anaemia."

Clinical • Journal • Anemia • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease