Patient Protection and Affordable Care Act (PPACA) Centers for Medicare & Medicaid Services

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

Manatt on Medicaid: Montana Governor Signs Act to Expand Medicaid

On April 29, 2015, Montana Governor Steve Bullock signed Senate Bill 405, referred to as the Montana Health and Economic Livelihood Partnership Act (HELP Act), which expands Medicaid to cover an estimated 70,000 new adults....more

Challenge to DSH Adjustment Estimates Barred by Statute

In a decision issued on March 31, the United States District Court for the District of Columbia dismissed a challenge by Florida Health Sciences Center, Inc., also known as Tampa General Hospital, to the calculation of its...more

Health Care Enforcement: The Impact on Private Equity Investments [Video]

Brian Platton provides an overview of enforcement trends that private equity investors should be aware of before entering into the health care space....more

Washington Healthcare Update

This Week: Energy and Commerce Health Subcommittee Explores Post-Acute Bundling…CMS Releases First-ever Hospital Compare Star Ratings…Fiscal Year 2016 Proposed Inpatient and Long-term Care Hospital Policy and Payment Changes....more

CMS Proposes 1.7% Increase in Medicare IRF PPS Payments for FY 2016

On April 23, 2015, CMS released its proposed rule to update Medicare prospective payment system (PPS) rates for inpatient rehabilitation facilities (IRFs) for FY 2016, which begins October 1, 2015. CMS estimates that rates...more

MACRA’s Advancement of EHR Interoperability and Telehealth

This is the fourth and final post in our series on the Medicare Access and CHIP Reauthorization Act (MACRA). Pub.L. No. 114-10. We’ve previously covered the repeal of the Sustainable Growth Rate (SGR) in our April 20th post,...more

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

This week, CMS proposes continued 90% funding for Medicaid eligibility and enrollment system development. Montana is on the verge of becoming the 29th state (plus D.C.) to expand Medicaid eligibility, and Florida Governor...more

CMS Issues Guidance on Reimbursement for Biosimilars under Medicare and Medicaid

Biosimilars Are Generally Treated as Single Source Drugs - On March 30, 2015, in the wake of the first biosimilar product licensed by the Food and Drug Administration (FDA), the Centers for Medicare & Medicaid Services...more

Federal Trade Commission and Department of Justice Hold Joint Workshop on Payment Models and Competition Within the Health Care...

On February 24-25, 2015, the Federal Trade Commission (“FTC”) and Antitrust Division of the Department of Justice (“DOJ”) co-hosted a second public workshop as part of the “Examining Health Care Competition” series to study...more

Health Care Update - April 2015

In This Issue: - SGR Bill Facing Final Hurdles This Week - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health Care...more

Healthcare Legal News Volume 5 Number 2

According to a recent study by Accenture, by 2017 approximately 18 percent of the American public will purchase insurance through exchanges versus relying on traditional employer healthcare coverage or foregoing insurance...more

"Next Generation" ACO Model Announced by CMS

In a March 10, 2015 press release, CMS announced a new addition to its existing Accountable Care Model (ACO) portfolio: Next Generation ACOs. As stated by CMS in its press release, this new ACO model will allow for already...more

Washington Healthcare Update

This Week: CMS Releases Three Documents on Biosimilar Reimbursement... SCOTUS: Agencies, Not State Courts, in Charge of Medicaid Rate Setting... HHS OIG and Treasury IG Release Report on ACA’s Advanced Premium Tax Credits....more

New Postings on the Reed Smith Health Industry Washington Watch Blog - March 2015

The Reed Smith Health Industry Washington Watch blog has been updated to report on recent health policy developments, including the following...more

Washington Healthcare Update

This Week: House Approves FY 2016 Budget Proposal... House Passes Permanent SGR Reform and Two-Year CHIP Reauthorization... Senate Passes FY 2016 Budget Plan... HHS Report: ACA Led to $7.4 Billion Decline in Uncompensated...more

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

This week, Alaska’s Governor introduced Medicaid expansion bills in both the House and Senate after failing to get approval in his budget. Colorado determined that non-ACA-compliant plans cannot be sold in 2016, a year ahead...more

Health Care E-Note - March 2015

In This E-Note: - Health Care Reform in America: The Good, The Bad and The Ugly - The Federal False Claims Act - Violations of Conditions of Payment or Conditions of Participation? - State Regulatory...more

Also In The News - Health Headlines - March 2015

CMS Releases 2015 Impact Assessment of Quality Measures Report – On March 2, 2015, CMS released the 2015 National Impact Assessment of Quality Measures Report, which assesses the effectiveness and impact of quality measures...more

CMS Rule on Medicare Overpayments? Don’t Hold Your Breath

Since the Center for Medicare & Medicaid Services proposed a rule three years ago suggesting that providers could be liable for returning Medicare overpayments going back ten years, providers have been anxiously awaiting a...more

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

King v. Burwell speculation has been rampant since the Supreme Court heard oral testimony on Wednesday. All eyes are on Justices Kennedy and Roberts, who are likely to wield the deciding votes. In other news, CMS approved a...more

CMS Delays Publication of Final Rule Regarding Reporting and Returning of Medicare Overpayments

One of the most challenging compliance changes brought about by the Affordable Care Act (ACA) is the provision mandating the reporting and refunding of Medicare and Medicaid overpayments within 60 days of the date they are...more

Health Care Update - March 2015

In This Issue: - King v. Burwell before the Supreme Court and the Potential Congressional Response - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

CMS Finalizes 2016 ACA Marketplace Plan Benefit & Payment Parameters

The Centers for Medicare & Medicaid Services (CMS) has finalized its Affordable Care Act (ACA) Marketplace health plan payment parameters and essential benefit standards for 2016. ...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

Centers for Medicare and Medicaid Services Delays Overpayment Final Rule

The Centers for Medicare and Medicaid Services (CMS) announced on February 13, 2015, that it will delay publishing final regulations concerning the “60-Day Rule.” The final rule will be published on or before February 17,...more

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