Health Care Insights - Spring 2012 by Pullman & Comley, LLC on 5/17/2012 In This Spring 2012 Issue: Surgical Resident's Suit Fails; Healthcare Reform Impact Noted; New Hospital Affiliation Announced; Impact of Financial Incentives; and, Why Hospital-Owned Medical Groups Lose Money....more
CMS Issues Proposed Rule on Increasing Payment for Primary Care by King & Spalding on 5/17/2012 On May 9, 2012, CMS issued a proposed rule that seeks to increase Medicaid payments for certain primary care services. Among other changes, the proposed rule: •Implements the Affordable Care Act’s requirement that...more
HEALTH REFORM: Alternative Provider Reimbursement Models – How Are They Treated Under MLR Rules? by Epstein Becker & Green, P.C. on 5/17/2012 In a recent health reform alert, “New Rules Issued on Medical Loss Ratio Requirements,” we described the rules issued by the Centers for Medicare & Medicaid Services ("CMS") and the U.S. Department of Health and Human...more
CMS Publishes Final Rule on Community First Choice Option by King & Spalding on 5/16/2012 On May 7, 2012, CMS published a final rule on the Community First Choice (CFC) program. CFC is a new state Medicaid option — established by Section 2401 of the Affordable Care Act — under which participating states provide...more
Legal Alert: COBRA Audits Updated by Ford & Harrison LLP on 5/16/2012 Executive Summary: The IRS recently issued revised guidelines for field agents who are conducting reviews of employers' COBRA compliance. Under the new guidelines, the IRS requires that any COBRA audit should at least...more
New Guidance on Summaries of Benefits and Coverage by Ballard Spahr LLP on 5/16/2012 The U.S. Department of Labor (DOL) has issued additional guidance on the summaries of benefits and coverage (SBCs) that the Affordable Care Act will require many health plan sponsors to distribute as early as this...more
Is a Simple Cafeteria Plan Right for You? by McKenna Long & Aldridge LLP on 5/16/2012 This is part of our series of alerts intended to help guide employers and plan sponsors through their new obligations under the health care reform laws and related guidance. You may have heard that you can establish a...more
Health Law Alert: Massive Criminal Takedown Is Latest Salvo in Government's Intensified Campaign Against Health Care Fraud and... by Ober|Kaler on 5/15/2012 On May 2, 2012, the Justice Department and the U.S. Department of Health and Human Services (HHS) announced a nationwide takedown of 107 individuals for Medicare fraud schemes involving approximately $452 million in false...more
HHS Officials Explain Risk Adjustment Methodology by Mintz Levin - Health Law on 5/15/2012 On May 7th and 8th, the Center for Consumer Information and Insurance Oversight (CCIIO) held a public meeting on risk adjustment, the process through which, under the Affordable Care Act (ACA), funds are transferred from...more
May 2012: Appellate Litigation Update: Supreme Court to Review Patient Protection and Affordable Care Act by Quinn Emanuel Urquhart & Sullivan, LLP on 5/15/2012 Supreme Court to Review Patient Protection and Affordable Care Act: In one of the most important and closely watched cases in recent memory, the Supreme Court this Term will decide the constitutionality of the Patient...more
Your Company’s Wellness Program Could Be In Violation Of GINA by Miller Canfield on 5/15/2012 Does Your Company’s Wellness Program Violate GINA? The Genetic Information Non-Discrimination Act (GINA) expressly prohibits covered employers and health plan sponsors from asking an employee to provide genetic...more
State of the States: Health Insurance Exchanges -- May 11, 2012 by McKenna Long & Aldridge LLP on 5/14/2012 After various states took steps last week to move forward with exchange legislation, this week some states that were moving ahead with exchange legislation have now slowed their pace. Yesterday, just after the clock...more
CMS Proposes Changes to Medicare Inpatient Prospective Payment System for Fiscal Year 2013 by McDermott Will & Emery on 5/14/2012 The Centers for Medicare & Medicaid Services (CMS) has posted a more than 1,300-page proposed rule that would update Medicare’s Inpatient Prospective Payment System for fiscal year 2013. Parties affected by the proposed...more
New Jersey Governor Vetoes Health Insurance Exchange Bill by Saul Ewing LLP on 5/14/2012 Governor Chris Christie vetoed legislation on May 10, 2012 that would have mandated the formation and development of a "health insurance exchange" in the state, as contemplated under the federal Patient Protection and...more
Health Plans Have an Added Mandatory Disclosure under ERISA by Constangy, Brooks & Smith, LLP on 5/14/2012 Summary of Benefits and Coverage. Health care reform expands ERISA's disclosure requirements by requiring that group health plans provide a summary of benefits and coverage (“SBC”) to plan participants and beneficiaries...more