Health Insurance

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The ERISA Litigation Newsletter - July 2015

Editor's Overview - This month's article by Lindsey Chopin discusses Affordable Care Act ("ACA") litigation. Just five years old, the Supreme Court has considered issues related to the ACA numerous times. Two of those...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 2 of 24): Yikes! The Costs of Failing to Comply...

The Affordable Care Act (ACA) imposes information reporting rules on providers of minimum essential coverage, e.g., insurance carriers and self-funded plans, and on applicable large employers, i.e., those employers that are...more

IREG Update - July 2015

Provider-Sponsored Carriers - A new trend in the provision and financing of health care is the forming of health carriers by health systems and provider groups. This trend follows the emphasis on managing health care...more

Does Delaware’s New Telemedicine Law Foreshadow Broader Payment Parity?

Nationwide, states continue to enact laws requiring commercial health plans to cover medical services provided via telemedicine to the same extent they cover medical services provided in-person. These laws are intended to...more

Also In The News - Health Headlines - July 2015

CMS Reopens Attestation Period For First-Time Hospitals Until August – CMS recently announced that eligible hospitals participating in the Medicare Electronic Health Record Incentive Program for the first time in 2015 may...more

Health Update - July 2015

Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace - Editor's Note: As marketplaces prepare for the third open enrollment period, consumers are...more

Health Alert (Australia) - July 20, 2015

In This Issue: New South Wales (NSW). 14 July 2015 - Ping Yuan v Da Yong Chen [2015] NSWSC 932 The New South Wales Supreme Court has made a declaration allowing an unconscious man's wife to consent to the...more

Trade Act Reinstates Expired Health Coverage Tax Credit (HCTC)

On July 6, 2015, President Obama signed the Trade Preferences Extension Act of 2015. Among other things, the Trade Act retroactively reinstated the Health Coverage Tax Credit (HCTC), which had previously expired on January...more

Health Care Rep and Warranty Insurance: New Solutions for Private Equity Buyers and Sellers

Whether in an auction or proprietary transaction, risk allocation has typically been a function of indemnities tied to reps and warranties and the type of credit supporting the type of supporting credit. Holdbacks, earnouts,...more

Washington Healthcare Update

This Week: 21st Century Cures Legislation Passes House in Bipartisan Vote... CMS Releases Proposed CY 2016 Home Health Prospective Pay Rule... CMS Releases Final CY 2016 Hospital Outpatient Prospective Payment System (OPPS)...more

Manatt on Health Reform: Weekly Highlights - July 2015 #2

Montana’s Medicaid expansion waiver seeks monthly premiums and a “third party administrator”; Rhode Island’s Medicaid working group recommends pursuing a DSRIP waiver; and Utah’s Medicaid expansion discussions are put on hold...more

The Supreme Court Addresses Federal Health Care Subsidies and Same-Sex Marriage

Two recent Supreme Court decisions have implications for employee benefit plan sponsors: King v. Burwell, decided June 25, 2015, and Obergefell v. Hodges, decided June 26, 2015....more

King v. Burwell Aftermath: Where Does the Health Care Industry Go From Here?

What was at stake in King v. Burwell? DH: Perhaps more than initially meets the eye. If the U.S. Supreme Court had sided with the King v. Burwell plaintiffs, federal tax subsidies to reduce the cost of insurance premiums...more

Health Care Update - July 2015 #1

In This Issue: - Recent Mandatory APMs Signal Evolution in Delivery Reform Efforts - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Upcoming...more

Aetna to Acquire Humana for $37 Billion

According to data supplied by the companies (pdf), Aetna is the larger of the companies, with 23.67 million medical members to Humana’s 9.77 million. Aetna also has a larger dental insurance business, with 15.56 million...more

Reminder: Non-Grandfathered Plans Must Implement Embedded Out-of-Pocket Maximums

As employers and plans prepare for 2016 open enrollment, they must be sure to address in their benefit design and with their third party vendors the new embedded out-of-pocket maximum limitations on individuals that were...more

Agencies Issue Final Regulations on the Summary of Benefits and Coverage (SBC) Requirements

As promised in the FAQ issued on March 30, 2015, the U.S. Departments of the Treasury, Labor and Health and Human Services (the Departments) have issued final regulations regarding the summary of benefits and coverage (SBC)...more

"King v. Burwell: Round 2 for the Affordable Care Act"

On June 25, 2015, the U.S. Supreme Court announced its long-awaited decision in King v. Burwell. The Court concluded that statutory language in the Affordable Care Act (ACA) authorizing tax credits for consumers on “an...more

IRS Notice 2015-43 Addresses Expatriate Health Coverage

New guidance from the Internal Revenue Service (IRS) leaves in place the limited Affordable Care Act (ACA) exemptions set out in the Expatriate Health Coverage Clarification Act of 2014 (EHCCA). IRS Notice 2015-43 (Notice)...more

Connecticut to Tighten Data Privacy Requirements

On June 1, 2015, the Connecticut Legislature passed S.B. 949, a comprehensive data privacy and security bill that tightens the state’s data breach response requirements and imposes new obligations on state contractors and the...more

New ruling limits out-of-pocket expenses at individual level in 2016

Most health plan and health insurance policies include strategies that require persons covered under them to share in the costs that are paid. This strategy, often referred to as cost-sharing, serves two purposes. First, it...more

Delaware Enacts Telehealth Commercial Insurance Parity Law

Declaring “liberty and independence” from the constraints of brick and mortar health care, Delaware became the 29th state to enact a telemedicine commercial reimbursement statute. The legislation (HB-69) was sponsored by...more

Manatt on Health Reform: Weekly Highlights - July 2015

Ohio passes a budget mandating that the State request a waiver to implement Medicaid Health Savings Accounts; in Nevada, Marketplace enrollees who experienced technical difficulty obtaining coverage are eligible for a...more

Blog: States Strengthen Laws Addressing Health Information Handling and Breach Response

Connecticut and Oregon were recently added to the increasing list of states adopting stricter laws addressing the handling of health information and penalties in connection with breaches of health information. Both states...more

How to Comply With the Affordable Care Act's Employer Mandate

The Affordable Care Act (“ACA”) is the most far-reaching piece of employee benefits legislation passed in the last 40 years. With over 20,000 pages of regulations and other guidance, the ACA is profoundly affecting our...more

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