Health Care Reform Update

Implementation of Health Care Reform Law On Monday, November 29th Centers for Medicare and Medicaid Services (CMS) officials spoke at an “opendoor” forum to outline the agency’s near-term plans for accountable care organizations (ACOs), payment innovation, and new methods for providing care to the “dual eligibles”—Americans dually eligible for coverage under Medicaid and Medicare. Deputy CMS Administrator Jon Blum noted that CMS wants to encourage solo practitioners and small group practices to take part in ACOs. Richard Gilfillan, the acting director of the new Center for Medicare and Medicaid Innovation (CMI), noted that his office is developing an operating plan for testing new payment systems, and Melanie Bella, head of the Federal Coordinated Health Care Office, noted that her office is in the process of identifying ways that Medicare and Medicaid conflict as well as legislative and regulatory fixes to removing those barriers to care.

A federal judge in Virginia on November 30th threw out a challenge to the Affordable Care Act (ACA) brought by Liberty University and five individuals, including a state lawmaker. In his ruling, Judge Norman Moon of the Western District of Virginia said that the individual mandate was constitutional and a matter of regulation of interstate commerce allowed under the Commerce Clause of the Constitution. In the same ruling, Judge Moon also upheld the requirement that employers provide insurance as constitutional.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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