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

Health Coverage Providers: Deadlines for Health Coverage Providers to Report Minimum Essential Coverage are Approaching

Who Must Report? If you are a health insurance issuer, self-insured employer, or other entity that providedminimum essential coverage (MEC) during calendar year 2015, including a state government providing Medicaid or...more

The Affordable Care Act’s Reporting Electronic Backbone—The AIR System

For the last half of 2015, we spent a good deal of time explaining the Affordable Care Act reporting requirements that applied to carriers and large employers. This post examines the how of ACA reporting. In particular, it...more

Staffing Firms, Educational Organizations, and Breaks-in-Service under the Affordable Care Act Employer Shared Responsibility...

In Q&A format, recently issued Notice 2015-87 addresses a number of pressing issues that have arisen under the Affordable Care Act (ACA), including that law’s employer shared responsibility rules, information reporting...more

CMS Eases 60-Day Overpayment Requirement in Final Rule While Raising New Questions

On February 11, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released the long awaited final rule clarifying the statutory requirement under the Affordable Care Act for providers and suppliers to report and...more

60-Day Overpayment Final Rule Eases Obligations for Health Care Providers But Still Reinforces Need for Vigilance

On Feb. 11, the Centers for Medicare & Medicaid Services (CMS) published a final rule relating to the overpayment providers receive from federally funded health care programs. While the rule eases some of the burden for...more

What the Administration Actually Can Do on Drug Pricing

The President’s budget makes clear for all to see that the Administration wants to do something related to drug pricing. Unfortunately for the Administration, most of their proposals require Congressional authority that have...more

CMS Finalizes 60 Day Overpayment Rule

The final rule relaxes the requirements on “identification” and look-back period. The Centers for Medicare & Medicaid Services (CMS) has released its long-awaited final rule related to the reporting and refunding of...more

Breaking News: 60-Day Overpayment Rule Finalized

The Centers for Medicare and Medicaid Services (CMS) released its final rule implementing Section 6402(a) of the Affordable Care Act that requires Medicare providers and suppliers to report and return overpayments within 60...more

CMS Clarifies 60 Day Overpayment Rule

The Department of Health and Human Services’ (HHS) Center for Medicare and Medicaid Services (CMS), is set to publish a final rule that will provide some much needed relief to healthcare providers from the burdens of the...more

CMS Issues Final Overpayment Rule: A Guide On How To Eat An Elephant

On February 11, 2016, the Centers for Medicare & Medicaid Services (CMS) released its final rule (the “Final Rule”) implementing Section 6402(a) of the Affordable Care Act, which created a new Section 1128J(d) of the Social...more

Deciphering the Final AMP Rule – Key Provisions Impacting Pharmacies, PBMs, and Manufacturers

In late January, the Centers for Medicare & Medicaid Services (“CMS”) released the much anticipated Covered Outpatient Drugs Final Rule with Comment (the “AMP Final Rule”). The rule creates the regulatory definition for...more

Employment Matters Monthly - February 2016

A Note from the Editors - If January was a harbinger of what's in store for 2016, it's sure to be a busy year for HR professionals and employment attorneys. And Employment Matters is certainly here to guide you along the...more

OSHA Incorporates Previous Guidance into Whistleblower Manual

The Occupational Safety and Health Administration (OSHA) has issued a new Whistleblower Investigations Manual that clarifies the new, relaxed standard to be used by its investigators in determining whether to pursue a...more

OMB Finalizes Review of 60-Day Overpayment Rule

The Office of Management and Budget completed its review of the long-awaited final rule establishing a process for Medicare Part A and B providers and suppliers to report and return overpayments within 60 days (the “60-day...more

Subsidizing Student Health Insurance With Stipends – New Agency Guidance and Relief

On February 5, 2016, the Departments of the Treasury, Labor, and Health and Human Services (the Departments) issued guidance addressing the application of market reforms and other provisions of the Affordable Care Act (ACA)...more

FAQs Regarding The ACA's Employer Reporting Requirements And Delay Of Reporting Requirements (Part 2 Of 2)

A few weeks ago, we provided the most Frequently Asked Questions regarding the employer reporting requirements under The Patient Protection and Affordable Care Act (the "ACA"), which are generally effective beginning January...more

Manatt on Health Reform: Weekly Highlights - February 2016 #2

CMS details requirements for Kentucky's transition to HealthCare.gov; a new special enrollment period is established for subsidy-eligible individuals who failed to file their 2014 taxes; and President Obama sends his final...more

Questionable Retaliation Theory Gets Traction

Since our earliest postings, we have warned of a notion, prevalent among employee counsel, that an employer plan sponsor unlawfully retaliates against an employee by reducing her work hours in order to deprive her of ACA...more

ACA Reporting Deadlines Relaxed for 2016

Following complaints, concerns and continuing questions relating to the Affordable Care Act reporting requirements, the IRS has relaxed reporting deadlines for 2016 in the form of IRS Notice 2016-4. As you may be aware,...more

Washington Healthcare Update

This Week: Congress and the administration focus on the opioid addiction epidemic... Override of the president’s veto of legislation that would have repealed the Affordable Care Act fails, to no one’s surprise... Senate...more

IRS Delivers Belated Christmas Gift – Extends ACA Reporting Deadlines

The IRS delivered a late Christmas gift December 28, 2015 when, in Notice 2016-4, it extended the Affordable Care Act (“ACA”) reporting deadlines.  The new deadlines affect distribution and filing of Forms 1094 and 1095 for...more

CMS Finalizes Long-Awaited Covered Outpatient Drug Rule

The Centers for Medicare & Medicaid Services (“CMS”) recently issued a final rule implementing provisions of the Patient Protection and Affordable Care Act of 2010 (“ACA”) that pertain to Medicaid reimbursement for covered...more

OIG Interim Evaluation of ACA LTC Employee Background Check Grant Program

The HHS Office of Inspector General (OIG) has issued an interim evaluation report on an Affordable Care Act (ACA) program that provides grants to states to implement background check programs for prospective long-term care...more

Employee Benefits & Executive Compensation Advisory: IRS Notice 2015-87 Provides Much-Needed Guidance for Account-Based Plans and...

In IRS Notice 2015-87, the agencies provided further clarification on the impact of the Affordable Care Act (ACA) group health plan market reform provisions on account-based plans and much needed guidance on the Section 4980H...more

Health and Welfare Plans: Big Compliance Burdens, Big Penalty Exposures

Health and welfare have been around for a long time, and they are ubiquitous. Employees have come to expect medical, dental, life, and other insurance as part of their benefits packages. Employers offer coverage in order to...more

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