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

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 -
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2015 Notice of Benefit and Payment Parameters

The Centers for Medicare & Medicaid Services (CMS or the agency) kicked off a flurry of springtime regulatory activity for health insurance issuers with publication of the final Notice of Benefit and Payment Parameters for...more

Health Care Reform Update - March 3, 2014

In This Issue: Implementation of the Affordable Care Act; Other Federal Regulatory Initiatives; Other Congressional and State Initiatives; and Hearings and Mark-Ups Scheduled. Excerpt from Implementation of the...more

CMS Issues Draft Letter with 2015 Affordable Care Act Plan Certification Requirements

On February 4, 2014, CMS released a Draft Letter containing guidance for issuers seeking to offer Qualified Health Plans (QHPs) in Federally-Facilitated Marketplaces (FFMs). The Draft Letter offers operational and technical...more

The Year to Come for General Counsel: Payment Reform, Managed Care and Affiliations - Part 1: Payment Reform Four Years After the...

Part one of a three-part series - As the public begins to navigate the health insurance exchanges and healthcare.gov cleans up its glitches, executive leadership of most health systems, hospitals and physician...more

Health Insurance Exchange Enrollees Now Eligible to Receive Benefits – Providers Should Be Ready To Verify Patients’ Health...

Beginning January 1, 2014, Americans who purchased a health insurance plan through the Health Insurance Marketplace (often referred to as the “Exchange”) on or before December 24, 2013 are now covered by those plans. Health...more

The Affordable Care Act Comes Of Age

Since President Obama signed the Patient Protection and Affordable Care Act (ACA) in March 2010, various provisions of the law have taken effect. However, its core pieces become effective this year....more

2013 – The Health Law Year in Review

As 2013 draws to a close, we are pleased to look back on the year that was and highlight some of the key developments in the ever-changing field of health law. While a great deal of attention was focused on the implementation...more

Health Care Reform Implementation Update - December 19, 2013

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

Health Care Reform Update -- November 25, 2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; and Hearings and Mark-Ups Scheduled. Excerpt from...more

CMS Letter to State Insurance Commissioners Offers Transitional Policy to Prevent Health Insurance Issuers from Cancelling Plans...

On November 14, 2013, the CMS Center for Consumer Information and Insurance Oversight issued a letter to State Insurance Commissioners announcing a “transitional policy” to permit health insurance issuers to continue plan...more

Ordering/Referring Provider Edits To Be Turned On Effective January 6, 2014

On November 6, 2013, CMS announced that it plans to turn on claims processing edits (effective January 6, 2014) to deny Part B clinical laboratory and imaging, and DMEPOS, and Part A home health agency claims that fail...more

Dodging the AKS: Marketplace Plans Are Not "Federal Health Care Programs"

In an October 30th letter addressed to Congressman Jim McDermott, the Department of Health and Human Services (HHS) Secretary, Kathleen Sebelius, left little to interpretation: Qualified health plans (QHPs) purchased through...more

Health Care Reform Implementation Update - November 5, 2013

Criticism of the Affordable Care Act’s exchange rollout continued this past week. The main line of attack has moved from the malfunctioning website to canceled plans despite President Obama’s repeated promise that those who...more

Health Care Reform Update -- November 5, 2013

In This Issue: Leading the News; Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearings and Mark-Ups...more

Health Care Reform Implementation Update - October 29, 2013

Repair work to Healthcare.gov is underway, and White House advisors are now pledging that it will be functioning smoothly by the end of November. However, the system was met with new problems over the weekend when the...more

Health Reform + Related Health Policy News - October 2013

In This Issue: - Top News ..Judge Orders $237.4 Million Penalty Against Tuomey for Stark Law and False Claims Act Violations ..Glitches and Demand Lead to Marketplace Frustration ..HHS Delays Small...more

Health Insurance Marketplace Implementation Continues

The flow of traffic on HeathCare.gov on Tuesday, October 1, described by a representative from the Centers for Medicare & Medicaid Services (“CMS”) as “historic,” reportedly reached up to 2.8 million users, as individuals...more

Insights on Arkansas’s “Private Option” Medicaid Expansion

On September 27, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Arkansas’s waiver to implement the Affordable Care Act (ACA) Medicaid expansion by using premium assistance to purchase QHPs in the Health...more

Will the Shutdown Kill Obamacare?

The current government standoff is over the conservative Republican effort to defund or delay the Affordable Care Act (ACA). Senate Democrats have vowed to reject any bill that cuts funding for the ACA, while House...more

Healthcare Law -- Sep 26, 2013

Engaging Consumers to Improve Integrated Care Models - Integrated care is a growing trend in health reform, as states seek to improve care quality, health outcomes and patient satisfaction while containing healthcare...more

Health Care Reform Implementation Update - September 24, 2013

With a week until a potential government shutdown and a week until open enrollment begins, the Affordable Care Act (ACA) is in the limelight. On September 20, the House voted for a continuing resolution that funds the...more

CMS Releases Final Rule Implementing Reductions of Federal Medicaid DSH Funding

On September 18, CMS published a final rule implementing reductions required by the Affordable Care Act (ACA) for the disproportionate share hospital (DSH) program. The Medicaid DSH program provides federal funding to...more

HHS Publishes Final Rule on Exchanges, SHOPs, and Eligibility Appeals

Final regulations required for October 1, 2013 open enrollment are largely unchanged from the proposed rule. On August 30, the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human...more

CMS Issues Final Program Integrity Rule for Affordable Insurance Exchanges

On August 30, 2013, CMS published a final rule establishing certain program integrity requirements for the private health insurance marketplaces—called Affordable Insurance Exchanges (or Health Insurance...more

Health Care Reform Implementation Update - August 26, 2013

In response to security concerns about personal information in the health insurance exchanges, the Centers for Medicare and Medicaid Services (CMS) released a new security agreement for the data hubs where this information...more

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