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Oral Argument in King v. Burwell Concludes; Debates Ensue

At approximately 10:00am EST this morning, the Justices of the U.S. Supreme Court heard oral argument in King v. Burwell – the highly publicized case whose final decision may “end Obamacare as we know it!” (as one excitable...more

CMS Issues Final 2016 Funding Methodology for ACA Basic Health Program

On February 24, 2015, CMS published its final methodology and data sources for determining federal payment amounts for states that elect to use the Basic Health Program to offer health benefits to low-income individuals...more

DOJ and FTC Announce Proactive Approach to Monitoring Post-Affordable Care Act Antitrust Compliance at Joint Workshop

On February 24 and 25, the DOJ and FTC held their second joint workshop to examine the state of health care competition in the United States. The workshop explored five main themes: early observations regarding accountable...more

Congress Begins With Renewed Efforts to Repeal Insurer’s Antitrust Exemption

Early into the 114th Congress, multiple bills have already been introduced that would repeal the insurance industry’s limited antitrust exemption granted by the McCarran-Ferguson Act (15 USC 1011 et seq.)....more

FTC and DOJ Host Workshop Examining Health Care Competition - Updated 2015

The Federal Trade Commission (FTC) and the Antitrust Division of the U.S. Department of Justice (DOJ) held a public workshop on February 24–25, 2015, to examine recent trends and developments in health care provider...more

Legal Alert: IRS Offers Rules of the Road for Cadillac Plan Tax

On February 23, the Internal Revenue Service (IRS) issued Notice 2015-16 (Notice), which describes several possible approaches for implementing the excise tax on high-cost employer-sponsored health care plans (also known as...more

Aetna Out of Patience With Hospital’s Alleged Out-of-Network Billing Scheme

Aetna Life Insurance Company (Aetna) is going on the offensive against a Northwest Houston hospital with an out-of-network strategy. On February 23, 2015, Aetna filed suit in Texas federal court against Robert A. Behar, M.D....more

On the Eve of Oral Arguments before the U.S. Supreme Court in King v. Burwell: Obamacare in the Balance

As every healthcare geek and Supreme Court wonk will tell you, on March 4, the U.S. Supreme Court will hear oral argument in King v. Burwell (an amalgamation of four cases – King v. Burwell, Halbig v. Burwell, Pruitt v....more

Health Alert (Australia) - March 2, 2015

In This Issue: Judgments; Legislation; and Reports. Excerpt from Reports: 23 February 2015 - Same-sex adoption a step closer with review of laws - Same-sex adoption in Victoria is a step closer,...more

Competition and Regulation Update: Health Sector Under ACCC Spotlight In 2015

ACCC ENFORCEMENT PRIORITIES - The Australian Competition and Consumer Commission (ACCC) has released its enforcement priorities for 2015, with the Chairman of the ACCC giving a speech on the topic last week. Each year,...more

In it Together -- Emerging Joint Venture Structures for Hospitals and Insurers

Locke Lord lawyers Jon Biasetti, Baird Allis and Benjamin Sykes provide a detailed look at recent efforts by hospitals, physician practice groups and health insurance and managed care companies to lower health care delivery...more

Five Health Care Developments Important to Employers

Perhaps never before have employers faced so many challenges when it comes to health care issues affecting their workforce. Congress may try to amend the Affordable Care Act (“ACA”). The Supreme Court of the United States is...more

Manatt on Health Reform: Weekly Highlights - February 2015 #4

Wrapping up the 2015 enrollment period, Healthcare.gov and State-based Marketplaces in seven states have announced special enrollment periods (SEPs) for people who were uninsured in 2014 and discover they owe a “shared...more

Health Care Update - February 2015 #3

In This Issue: - IRS in the ACA Spotlight - DOJ and FTC Examine Competition - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other...more

MNsure Audit Released

The Office of the Legislative Auditor (OLA) released its much-anticipated review of MNsure’s first year of operations. MNsure is Minnesota’s online health insurance marketplace that was established in accordance with the...more

Supplemental Excepted Benefits? “It depends.”

Last week, HHS, along with the Department of Labor and the Treasury, provided long overdue guidance regarding the third category of supplemental “excepted benefits” as defined by Section 2791 of the Public Health Services...more

Application For Recognition As A 501(C)(29) Organization

The Internal Revenue Service (IRS) and Department of the Treasury (Treasury) published in the January 29, 2015 Federal Register final income tax regulations (Regulations) describing procedures by which a qualified nonprofit...more

Employers with Group Health Plans: Have You Notified State Regulators of the Breach?

Data security breaches affecting large segments of the U.S. population continue to dominate the news. Over the past few years, there has been considerable confusion among employers with group health plans regarding the...more

Manatt on Health Reform: Weekly Highlights - February 2015 #3

Although the official February 15th enrollment deadline has now passed, the 2015 open enrollment period isn’t over for the Federally-facilitated Marketplace (FFM) and many State-based Marketplaces (SBMs).While the FFM...more

Health Care Update - February 2015 #2

In This Issue: - Open Enrollment Update - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health Care News -...more

Georgia Office of Insurance Issues Escrow Requirement Reminder to Continuing Care Communities

On February 9, the Georgia Office of the Insurance Commissioner (OIC) issued Directive 15-EX-1 reminding providers of continuing care and limited continuing care communities to maintain and demonstrate compliance with the...more

Locke Lord QuickStudy: Attention, Health Insurers: Unique Encryption Requirements in NJ

Setting a new standard for encryption, New Jersey has enacted a new law (P.L. 2014, c. 88, codified at N.J. Stat. Ann. §§ 56:8-196 - 56:8-198) effective August 1, 2015, requiring health insurance carriers authorized to issue...more

Anthem Data Breach Spawns Class Action Suits and “Phishing” Scams

Last week, Anthem Inc. – the nation’s second largest health insurer – reported a data breach involving the disclosure of the personal information of over 80 million patients and employees. Plaintiffs wasted little time...more

Cyber Attackers Reach Anthem, Health Care Providers Seen As Vulnerable

Anthem, one of the nation’s largest health insurers, announced last Wednesday that it had been attacked by cyber hackers and that personal information for as many as 80 million individuals had been compromised....more

The Anthem Data Breach: The Fallout and What’s Next

By now (unless you have been under a snow drift), you have likely heard about the apparent intrusion into a database at the nation’s largest health insurer, Anthem, Inc. Rather than reiterate the facts as currently known...more

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