Patient Protection and Affordable Care Act (PPACA) Health Insurance

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

Paying Employees to Opt Out of Insurance? BEWARE

Seyfarth Synopsis: That “win-win” in contract negotiation wherein employees are paid to opt out of employer insurance has become much more complicated thanks to the IRS. Basically, if bargaining parties do not follow new IRS...more

Recent Congressional Hearings

Congressional committees held hearings on a wide variety of on health policy issues this month before going on summer recess. Notable hearings include the following...more

DC Circuit strikes down HHS regulation regarding fixed indemnity plans

On July 1, 2016, in the case of Central United Life Insurance Company v. Burwell (No. 15-5310), the US Court of Appeals for the District of Columbia Circuit ruled that the US Department of Health and Human Services (HHS)...more

IRS Proposes Restrictions on Employer Opt-Out Payments for ACA Coverage Waivers

In early July the IRS issued proposed regulations addressing the effect that employer payments to employees who waive employer-sponsored health coverage, known as Opt-Out Payments, have on determining whether an ACA-covered...more

ColoradoCare Stands to Significantly Alter Health Care Services

In November, Colorado voters will cast ballots on Amendment 69, also known as ColoradoCare. ColoradoCare is an ambitious, far-reaching plan to amend the Colorado constitution which would establish a statewide universal...more

Best in Law: Beware of In-Lieu-Of Payments to Employees

Employers who allow their employees to opt for taxable cash payments in lieu of health benefits must consider the value of the payments when calculating overtime rates, a federal appellate court has ruled. Originally...more

New Federal Proposal May Make Health-Related Travel Insurance an Excepted Benefit Under ACA

For companies selling travel insurance products, there is major news out of Washington D.C. The Obama administration is seeking to curb short-term, limited duration health policies, which includes insurance products now...more

More Clarity on Expatriate Health Plans and the ACA

Expatriate health plans have been surprisingly difficult to reconcile with the Affordable Care Act (ACA). Proposed regulations set to take effect in 2017 provide some useful guidance to U.S. employers that sponsor expatriate...more

IRS Issues Proposed Regulations on Health Plan Opt-Out Payments

The Internal Revenue Service (“IRS”) has issued proposed regulations that include additional guidance on the treatment of employer-provided opt-out payments for purposes of affordability under the Affordable Care Act (“ACA”)....more

Injunction Enjoining Enforcement of HHS Attestation Rule Affirmed

The Court of Appeals for the District of Columbia affirmed the District Court’s decision in Central United Life v. Burwell on July 1, 2016. This decision is very significant for those assessing the future strength of, and...more

Federal Government Sued Over Emergency Physician Reimbursement Policy

Emergency physicians have long alleged that health insurance companies are unfairly and inconsistently setting low out-of-network reimbursements for emergency care, and now they are imploring the federal government to do...more

Major Changes To Nondiscrimination Requirements Under ACA Effective Soon: Are Covered Entities Ready?

The HHS Office of Civil Rights (“OCR”) published a final rule May 18, 2016, broadening the nondiscrimination requirements applicable to all health programs and activities receiving federal financial assistance from HHS, those...more

Issue 100: Agencies Propose ACA Regulations on Expatriate Plans and Excepted Benefits

This is the one-hundredth issue in our health care reform series of alerts for employers on selected topics in health care reform. (Our general summary of health care reform and other issues in this series can be accessed by...more

Republican Alternative to the Affordable Care Act Addresses the McCarran Ferguson Act's Antitrust Exemption

On June 22, Republicans in the House of Representatives announced a new proposal to "repeal and replace" the Affordable Care Act. While not formal legislation, the proposal – a 37-page policy statement entitled "A Better Way"...more

Deadline Reminder for Employers and Providers: Electronically File Information Returns with IRS by June 30

Self-insured employers, applicable large employers and health coverage providers are reminded that the June 30 deadline to electronically file information returns with the IRS is approaching. The deadline to provide...more

HHS Issues Final Rule On Nondiscrimination In Health Programs And Activities

On May 18, 2016, the United States Department of Health and Human Services ("HHS") Office for Civil Rights ("OCR") issued a Final Rule implementing Section 1557 of the Affordable Care Act ("ACA"), which prohibits...more

Obama Administration Asks Court to Dismiss ACA Risk Corridor Litigation

Yet another challenge is being brought against the Affordable Care Act (ACA), this time regarding the ACA's risk corridor program. The first of several lawsuits over this program was filed in February 2016 by an Oregon health...more

Maryland Co-Op Claims Risk Adjustment Formula Discriminates Against Smaller Insurers

Maryland’s Evergreen Health Cooperative has filed for an injunction against the federal government to halt payment by the Consumer Operated and Oriented Plan (co-op) of the $22 million it owes to CareFirst BlueCross...more

Transitioning to Coverage: Three Things to Know About the New Transgender Healthcare Regulations

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations implementing the nondiscrimination provisions of the Affordable Care Act. As we discussed in our March 30, 2016 blog, the rule...more

Tribal Employment and Jobs Protection Act Seeks to Exempt Native American Tribes from ACA

The Tribal Employment and Jobs Protection Act (H.R. 3080) could have a big impact on tribes if it becomes law. The legislation, which was passed by the U.S. House Ways and Means Committee June 15, seeks to exempt Native...more

HHS Issues Final Rule on ACA Nondiscrimination in Health Programs and Activities

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations interpreting the nondiscrimination provisions of Section 1557 of the Affordable Care Act (“ACA”). The rule mainly impacts insurers...more

HHS Final Rule Finds Categorical Exclusions for Health Services Related to Gender Transition Are Generally Unlawful

The U.S. Department of Health and Human Services (HHS) recently published its Final Rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of, among other grounds, sex in...more

How to Respond to a Notice From the Health Insurance Marketplace That Your Employee Has Qualified for an Advance Premium Tax...

Starting in 2016, the Federal Health Insurance Marketplace (the “Marketplace”) will send notices to applicable large employers whose employees received advance premium tax credits and cost-sharing reductions, if those...more

Healthcare Subsidies for Grad Students: An ACA Conundrum

Colleges and universities historically have provided graduate student employees (e.g., teaching assistants) with a stipend or reimbursement to help defray (or even fully cover) the cost of their medical coverage under the...more

Health Law Insights Newsletter - Issue 10 - June 2016

McCarter & English, LLP’s Health Care Group presents Issue 10 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - Drug Diversion Case Raises Red Flags for...more

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