Health Law, Insurance

Proper Disclosure and Documentation the Focal Point in New HIPAA and Medicare Rules

by Stacey Borowicz, Tyler N. Williams | Dinsmore & Shohl LLP on 5/21/2013

New HIPAA Rule Affects Providers’ Notice of Privacy Practices - The Health Insurance Portability and Accountability Act (“HIPAA”) requires health care providers to inform patients of the providers’ legal duties and the...more

Health Care Reform Blog: Bare Bones" Health Plans- Are They Legal?

by Susan J. Freed | Davis Brown Law Firm on 5/21/2013

You may have woken up today to media reports of large employers exploring the idea of dropping traditional health plans in favor of very limited health care plans as a way to lessen the burden imposed on large employers for...more

Florida Legislative Session 2013: Healthcare Summary

by Martin Dix, Steven Grigas, Bruce Platt, Sheryl D. Rosen | Akerman Senterfitt on 5/21/2013

The 2013 Florida Legislative Session concluded on May 3, 2013. The following is a partial summary of healthcare-related bills that may impact your business or practice. Note that some of these bills have become law, but...more

CMS Announces $1 Billion in Funding for Innovation Grants

by King & Spalding on 5/21/2013

On May 15, 2013, CMS released a funding opportunity announcement for round two of the Health Care Innovation Awards. The grants are administered by the CMS Innovation Center, which is authorized by the Affordable Care Act to...more

Health Care Reform Update -- May 20th, 2013

by Joseph P. Hammang, Alexander Hecht, Abby Matousek, Jeremy Rabinovitz | Mintz Levin - Health Law on 5/21/2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

OIG Releases Updated Provider Self-Disclosure Protocol

by John T. Bentivoglio, Jennifer L. Bragg, Maya Florence, Michael K. Loucks, Gregory M. Luce | Skadden, Arps, Slate, Meagher & Flom LLP on 5/21/2013

On April 17, 2013, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services released an updated Provider Self-Disclosure Protocol (SDP). As self-described, OIG updated the SDP to...more

CMS Announces Additional Open Period for Bundling Model 1

by King & Spalding on 5/21/2013

On Friday, May 17, 2013, CMS announced that its Center for Medicare and Medicaid Innovation Center (Innovation Center) is providing an open period for additional organizations to be considered for participation in Model 1 of...more

RAC Relief (Sort Of)

by Paul Kim | Ober|Kaler on 5/21/2013

CMS announced that it would reduce the number of additional documentation requests (ADRs) available to its Recovery Audit Contractors (RACs). ...more

Rx for HIPAA Compliance

by Mintz Levin - Privacy & Security on 5/20/2013

Weighing in at half the length of Tolstoy’s legendary tome War and Peace, it is no surprise that the thought of the impending deadline for compliance with the 538-page HIPAA Omnibus Rule has left many small clinical...more

The Affordable Care Act's Marketplace Notice: What Employers Need to Know

by Katie Morton, Mary Turk-Meena, Lynne Shore Wakefield | K&L Gates LLP on 5/20/2013

On May 8, 2013, the Department of Labor (“DOL”) issued long-awaited guidance on the notice that must be provided to employees by October 1, 2013, the first day of the Health Insurance Marketplace open enrollment period (the...more

Affordable Care Act Standards Related to Essential Health Benefits, Minimum Value, Actuarial Value and Accreditation

by Erin Jones Adams | Spilman Thomas & Battle, PLLC on 5/20/2013

On February 25, 2013, the Department of Health and Human Services (HHS) released its final rule (the Final Rule) setting forth standards for health insurance issuers under the Patient Protection and Affordable Care Act (the...more

Obamacare Loophole Allows Large Employers To Offer Bare-Bones Health Plans

by Joe Conley on 5/20/2013

On May 20, 2013, the Wall Street Journal reported that many large employers are looking to comply with the Affordable Care Act’s (“ACA”) employer mandate by offering bare-bones coverage that does not even cover...more

NOIs Due Soon to Apply for 2014 ACO Program

by Sarah E. Swank | Ober|Kaler on 5/20/2013

The Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs) established under the Affordable Care Act is about to kick-off its second year with a new round of applications for the January 1, 2014...more

DOL Releases Exchange Notice Guidance and Model Notices

by Dennis R. Bonessa, John D. Martini, Rachel Cutler Shim, Allison Warden Sizemore | Reed Smith on 5/17/2013

On May 8, the Department of Labor ("DOL") issued guidance regarding the requirement that employers provide notice to employees describing the coverage options available under Health Insurance Marketplaces (formerly known as...more

Health Law Alert: OIG Issues Updated Special Advisory Bulletin On The Effect Of Exclusion From Participation In Federal Health...

by Jessica Kracl, Sheva J. Sanders | Leonard, Street and Deinard on 5/17/2013

On May 8, 2013, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) issued an updated Special Advisory Bulletin on the effect of exclusion from participating in federal health care programs....more

Model Notices Issued To Meet Affordable Care Act Requirements – Notices Must Be Issued By October 1, 2013

by Andrew E. Graw | Lowenstein Sandler LLP on 5/17/2013

On May 8, 2013, the U.S. Department of Labor (DOL) issued guidance and model forms to assist employers in fulfilling their obligations under the Affordable Care Act (ACA) to notify employees of the availability of health care...more

Insurance Recovery Law -- May 16, 2013

by Manatt, Phelps & Phillips, LLP on 5/17/2013

In This Issue: Prepare For A Storm of Lawsuits; To Ensure Coverage, Read Policy Carefully; and Ticketmaster Wins Reversal, Possible Coverage For Class Action Over Ticket Fees ...more

CMS Proposes New Standard for Hospital Inpatient Admissions

by Leslie Demaree Goldsmith | Ober|Kaler on 5/17/2013

As part of its proposed inpatient prospective payment systems (IPPS) rule for FY 2014, CMS introduced a new standard for determining whether an inpatient admission to an acute care hospital is appropriate. Specifically, CMS...more

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

by Robert Wolin | BakerHostetler on 5/17/2013

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

IRS, Treasury Department Issue Proposed Rules Governing Minimum Value, Affordability, and Wellness Programs

by Alden J. Bianchi | Mintz Levin - Employment, Labor & Benefits on 5/17/2013

A key policy goal of the Patient Protection and Affordable Care Act (the “Act”) is the expansion of health insurance coverage to all Americans. The concepts of “minimum value” and its correlate “actuarial value” speak to the...more

Revisit Surveys To Slow Down Due To Budget Sequestration

by Jason Lundy | Polsinelli on 5/17/2013

As of April 5, 2013 and in response to budget sequestration, the Centers for Medicare & Medicaid Services (CMS) warns that revisit surveys for skilled nursing facilities will be delayed and approval requirements for...more

DOL (Finally) Issues Model Exchange Notice

by Jewelie Grape | Leonard, Street and Deinard - Employee... on 5/16/2013

On May 8, 2013, the Department of Labor (DOL) issued long-awaited temporary guidance and a model notice to be provided to employees about upcoming coverage options through the health care exchange, known as the Marketplace,...more

Raising the Stakes of Worker Misclassification Yet Again

by Morgan Lewis on 5/16/2013

New requirements under the Patient Protection and Affordable Care Act are set to intensify state and federal governments' crackdown on worker misclassification....more

Employers Must Notify Employees of the Availability of Health Insurance Exchanges - Employers Can Use Model Notices Issued by the...

by Allison De Tal, Isabel Safie, John Wahlin | Best Best & Krieger LLP on 5/16/2013

The Patient Protection and Affordable Care Act added Section 18B to the Fair Labor Standards Act (FLSA), requiring employers to give notice to employees of the coverage options available through state insurance exchanges....more

Health Care Reform Update: Employee Notice Requirements

by Colleen Lamarre, Sarah Ranni | Phillips Lytle LLP on 5/16/2013

The United States Department of Labor (DOL) has issued long-awaited guidance on the health insurance exchange notice requirement that applies under the Patient Protection and Affordable Care Act (PPACA). Generally, PPACA...more

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