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Administrative Agency Business Organization Insurance

Read need-to-know updates, commentary, and analysis on Administrative Agency issues written by leading professionals.

Financial Services Weekly News Roundup - April 2015 #5

by Goodwin on

Ninth Circuit Denies Rehearing of Northstar v. Schwab. On April 28, the U.S. Court of Appeals for the Ninth Circuit denied the petition of Schwab Investments’ (Schwab) for rehearing and rehearing en banc in the case of...more

New P&C Insurance Demutualization Regulations: Unknown Unknowns

On February 28, 2015, the Department of Finance released draft regulations under the Insurance Companies Act (Act) providing for a framework for the demutualization process applicable to mutual property and casualty insurance...more

The Future of Premium Subsidies under the Affordable Care Act: 'Halbig v. Burwell' and 'King v. Burwell'

by JD Supra Perspectives on

Both decisions addressed whether tax credits are available for residents in states that have federally-facilitated health exchanges. The District of Columbia Court of Appeals said “no”; the Fourth Circuit Court of Appeals...more

How Big Is Halbig? The Viability of the ACA’s Employer Mandate Hangs in the Balance

by JD Supra Perspectives on

For employers with employees in the 36 states with a federally facilitated exchange, the question arises how the Halbig decision impacts their decision and strategy to provide health coverage to their employees when the...more

The Affordable Care Act & the Impact on the C-Suite – Interview with Alden Bianchi, Member, Mintz Levin

by Mintz Levin on

Attorney Alden Bianchi, Practice Group Leader of Mintz Levin's Employee Benefits & Executive Compensation Practice, discusses why the Affordable Care Act makes health care benefits something that should be top-of-mind to...more

The Affordable Care Act: The Structure of Health Plans – Interview with Alden Bianchi, Member, Mintz Levin

by Mintz Levin on

Attorney Alden Bianchi, Practice Group Leader of Mintz Levin's Employee Benefits & Executive Compensation Practice, discusses how health plans will be purchased under PPACA....more

Corporate Governance Insights - Issue 1

We were delighted to hear from many of you that our recent statewide series of Insurance Company Corporate Governance Workshops with Pennsylvania Deputy Commissioner Stephen Johnson offered valuable information for directors...more

Medicare Shared Savings Program Grows by 106 ACOs in 2013

Yesterday the Centers for Medicare & Medicaid Services formally announced the 106 new Accountable Care Organizations (ACOs) participating in the 2013 Medicare Shared Savings Program (MSSP) cycle. CMS also announced that 15...more

Navigating the Provider Self-Disclosure Protocol

Providers can voluntarily disclose potential fraud with respect to Federal health care programs — Medicare, Medicaid, and potentially private insurers to the extent Federal or state funds are involved — by following the...more

GPL Insurance for Private Equity Firms – What Questions To Ask

by Mintz Levin on

Many private equity firms are concerned about their liabilities, including exposure to lawsuits for breach of fiduciary duty, claims for wrongful acts or omissions, and regulatory or securities investigations. One of the best...more

Policy Recommendations for States to Promote Accountable Care in Medicaid Programs

Federal and state health reform efforts present compelling opportunities to advance new payment and delivery system models to improve the quality of healthcare services and reign in costs. An emerging challenge for...more

Coordinated Care and Contracting: Pathology Participation in ACO's and Other Forms of Clinical Integration (Presentation)

by Jackson Walker on

In This Presentation: Learning Objectives: • Provide examples of alternative delivery and alternative payment mechanisms • Review the legal and business structures and risks of ACO type organizations • Help...more

Impact of Health Care Reform on Provider Liability: Issues and Proposed Solutions

In this presentation: - The Changing Healthcare Landscape - Examples of Quality Standards - Corporate Responsibility in Health Care Quality - Examples of Quality Enforcement Efforts - So Now...more

Mandatory Compliance Programs for Healthcare Companies

by Michael Volkov on

The healthcare industry always has taken the lead in compliance issues, developing innovative compliance tools and programs. Anti-corruption compliance borrows heavily from many healthcare compliance ideas....more

Closure of Stark Whole Hospital Exception Survives Court Challenge

by Jackson Walker on

On August 16, 2012, the United States Court of Appeals for the Fifth Circuit dismissed a challenge to the constitutionality of the Affordable Care Act ("ACA") provision that effectively eliminates the "whole hospital"...more

Is That Covered? Costs Of Government Investigations

Dealers are heavily subject to government regulation. From time to time, these government regulators conduct investigations into a dealer’s business operations and such investigations can be very costly to the regulated...more

Finding Insurance Coverage for the Cost of Government Investigations

Many businesses are subject to government regulation. From time to time, these government regulators conduct investigations into these business’ operations, which can be very costly and time consuming....more

The Supreme Court Ruled on Health Reform – What's Next for Medicaid and Medicare Managed Care Plans

The Affordable Care Act will present significant challenges and opportunities for Medicaid and Medicare managed care organizations. The Affordable Care Act ("ACA") is the single biggest overhaul of the United States...more

Insurance Rates On The Rise For San Fernando Valley Businesses

Insurance premiums for business policies in the San Fernando Valley have risen this year by two to fifteen percent compared to last year, according to David Russell, an associate professor of insurance and finance at...more

No Change in Course on ACA Federal Antifraud and Transparency Provisions

by Morgan Lewis on

Healthcare companies should work to comply with current provisions and prepare for those that will be implemented in the near future. The U.S. Supreme Court's decision that the Patient Protection and Affordable Care Act...more

New Public-Private Partnership Seeks to Combat Fraud

by King & Spalding on

On July 26, 2012, in further efforts to combat healthcare fraud, HHS Secretary Kathleen Sebelius and Attorney General Eric Holder announced a new partnership among the federal government, state officials, private healthcare...more

Telemedicine Amidst Healthcare Reform: Practicalities and Pitfalls

The Supreme Court’s recent decision upholding the Patient Protection and Affordable Care Act underscores the need to deliver and make accessible quality healthcare to patients throughout the United States in an efficient and...more

New ACO Developments Announced

by King & Spalding on

In two new Accountable Care Organization (ACO) developments, 15 of the 89 ACOs recently announced by CMS have been approved as “advance-payment” ACOs, which means they will receive some of their anticipated savings upfront to...more

340B Drug Pricing Program Experiencing Unprecedented Compliance Scrutiny

by Polsinelli on

Participants in the 340B Drug Pricing Program (340B Program) should be aware that over the last several months, the 340B Program has witnessed an unprecedented focus on oversight, integrity and enforcement. Although the 340B...more

Health Care Reform Update -- July 16, 2012

In This Issue: Implementation of the Affordable Care Act (ACA); Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearing & Markups...more

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