Patient Protection and Affordable Care Act (PPACA)

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
News & Analysis as of

CMS Issues Proposals Related to Payments Under Basic Health Programs

Last week, CMS proposed the payment methodology and data sources for Basic Health Programs (BHPs), which include state-level insurance coverage created by the Affordable Care Act (ACA) for low-income residents. The proposal...more

HHS Announces $840 Million Initiative to Improve Patient Care and Lower Healthcare Costs

Last week, the Department Health and Human Services (HHS) announced that it will invest $840 million over the next four years to support 150,000 clinicians through a combination of incentives, tools, and information to...more

CMS Launches $840 Million “Transforming Clinical Practice Initiative”

On October 23, 2014, CMS announced it would begin accepting applications for its “Transforming Clinical Practice Initiative,” a four-year initiative authorized by the Affordable Care Act. The new Initiative is designed to...more

Recent Employee Benefit Developments - October 2014

IRS Expands Cafeteria Plan Status Change Events - On September 18, 2014, the Internal Revenue Service issued Notice 2014-55, which establishes two new change in status events for cafeteria plans. The new change in...more

Health Care Update - October 2014 #4

In This Issue: - Ebola Response Taking a Multifaceted Approach - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives - Other...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 9: Misunderstanding “Offer[s] of Coverage on Behalf of Another...

Applicable large employers faced with the prospect of complying with the Affordable Care Act’s employer shared responsibility rules must grapple with and understand what is means to make an offer of minimum essential coverage...more

Counting on Hospice Care? Try to Hang on Until 2017

Yesterday’s Washington Post “Business of Dying” article is a sobering account of how little information is available on the quality—or lack of quality—of hospice organizations. Almost no information on quality is available...more

Considering a Wellness Program for Employees? Make Sure You Do Not Violate the ADA or Other Laws in the Process

Rising health insurance costs have bedeviled employers for years. Wellness programs represent one tool designed to increase employee health and reduce health insurance costs. The Affordable Care Act’s (“ACA”) so called...more

2015 Cost-of-Living Adjustments for Retirement and Other Benefit Plans

Retirement Plan Limits - The following limits apply to retirement plans in 2015: - The limit on elective deferrals under 401(k) and 403(b) plans has increased to $18,000 in 2015. - The annual limit on...more

Section 6055 Reporting of Health Plan “Minimum Essential Coverage” for Small and Large Employers

Starting in 2016, Section 6055 of the Internal Revenue Code, which was added by the Health Care Reform Act, requires all entities providing “minimum essential coverage” (MEC) to submit information to the IRS concerning each...more

HRAs Under the Affordable Care Act

Analysis: HRAs are employer-funded accounts designed to reimburse employees for out-of-pocket medical expenses. Employees are not permitted to contribute their own funds, so they are unlike flexible spending accounts or...more

Health Law Alert: OIG Releases Proposed Revisions to Anti-Kickback Safe Harbors and Civil Monetary Penalty Rules

The Department of Health and Human Services Office of Inspector General (OIG) recently released a proposed rule that revises safe harbors under the Anti-Kickback Statute (AKS) and Civil Monetary Penalty (CMP) rules regarding...more

Employer Reimbursement of Employee’s Individual Medical Insurance May Subject Employer to Penalty

IRS Notice 2013-54 provides that an employer’s reimbursement of healthcare insurance premiums paid by an employee on an individual health insurance contract of the employee on a pre-tax basis (an “employer payment plan”) may...more

Health Update - October 2014

Like It or Not, Obamacare Is Reshaping the Healthcare Industry - Editor’s Note: As we approach the one-year anniversary of Obamacare’s launch, the pundits continue to argue over whether or not it’s working. Meanwhile,...more

Affordable Care Act in Mergers and Acquisitions: New Guidance from Internal Revenue Service

In Notice 2014-49, the Internal Revenue Service (“Service”) issued guidance on how to avoid potential penalties under the Affordable Care Act (“ACA”) in connection with mergers and acquisitions (“M&A”). The notice provides a...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 10: What’s an Employer to Do (with Marketplace Notices)?

Under the Affordable Care Act’s employer shared responsibility rules, applicable large employers (those with 50 or more full-time and full-time equivalent employees on business days during the preceding calendar year) incur...more

Manatt on Health Reform: Weekly Highlights

Welcome to the first publication of the “Manatt on Health Reform: Weekly Highlights” newsletter. Many of you are familiar with the healthcare reform tracking efforts and weekly newsletters we produced for the KidsWell...more

Analysis of HHS OIG Proposed Rule to Amend the Anti-Kickback Safe Harbors, CMP Rules on Beneficiary Inducements & Gainsharing...

On October 3, 2014, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) published a major proposed rule that would amend the safe harbors to the Anti-Kickback Statute (AKS) and the Civil...more

OIG Announces Proposed AKS and CMP Regulations

On October 3, 2014, the Office of the Inspector General (“OIG”) issued a proposed rule codifying into regulation several statutory changes to the Antikickback Statute (“AKS”) and the Civil Monetary Penalty (“CMP”) Law. Nearly...more

OIG Special Advisory Bulletin Provides Guidance on Application of Federal Anti-Kickback Statute to Pharmaceutical Manufacturer...

In recent years, copayment coupon programs have become standard promotional practices for both large and small pharmaceutical manufacturers. Copayment coupons are typically offered to commercially insured patients in order to...more

Health Care Update - October 2014 #3

In This Issue: - Policymakers Scrambling to Contain Ebola Crises - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives -...more

OIG Proposes New Safe Harbors to the Anti-Kickback Statute and New Exceptions to the Two Civil Monetary Penalty Provisions

On October 3, 2014, the Department of Health and Human Services’ Office of Inspector General (“OIG”) published a proposed rule (“Proposed Rule”) to add new safe harbors to the federal health care program anti-kickback statute...more

Has the Affordable Care Act influenced COBRA? What if my employer fails to offer COBRA?  [Video]

Phoenix business law firm Jaburg Wilk's Employment law attorney Kraig Marton discusses how the Affordable Care Act has influenced or changed COBRA coverage. He also discusses what happens if a former employer fails to offer...more

Proposed Updates to the Civil Monetary Penalties Law for Health Care Providers

On October 3, 2014, the Office of Inspector General of the Department of Health and Human Services (“OIG”) published a proposed rule and request for comments (“Proposed Rule”) that would amend certain rules under the Civil...more

Providers Challenge CMS's Non-Hospital Rotation Rules for GME and IME

Prior to the enactment of the Affordable Care Act (ACA), CMS required hospitals to comply with a number of exacting payment and documentation rules in order to include as part of their graduate medical education (GME) and...more

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