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Patient Protection and Affordable Care Act (PPACA) › Health Insurance › Healthcare

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 -
Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

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Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Mintz - Health Care Viewpoints

2024 Pre-Election Analysis: Health Care Issues

Mintz - Health Care Viewpoints on

In recent elections, health care has been one of the most hot-button issues with consequences for millions of Americans, and this election is no exception. The next administration and the 119th Congress have the potential to...more

Epstein Becker & Green

Affordable Care Act Overpayments in the CY 2025 Medicare Physician Fee Schedule Proposed Rule: Implications for False Claims

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Stakeholders are continuing to analyze the implications of the mammoth proposed rule on “Medicare and Medicaid Programs: [Calendar Year (CY)] 2025 Payment Policies under the Physician Fee Schedule and Other Changes to Part B...more

ArentFox Schiff

The Accelerating Kids’ Access to Care Act: Breaking Barriers for Pediatric Patients Across State Lines

ArentFox Schiff on

In July 2023, US Senators Michael Bennet (D-CO) and Chuck Grassley (R-IA), along with US Representatives Lori Trahan (D-MA) and Mariannette Miller-Meeks (R-IA), introduced legislation to improve access to critical care for...more

Hall Benefits Law

HHS Issues Proposed Rule on Nondiscrimination in Health Programs and Activities

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” The proposed rule, designed to advance health equity and protect people from...more

Ballard Spahr LLP

Final Section 1557 Rules: Highlights for Health Plan Sponsors

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The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more

Verrill

Can a Self-Funded Group Health Plan Exclude Coverage for Gender-Affirming Care?

Verrill on

We are sometimes asked whether a self-funded group health plan is required to cover gender-affirming medical services. As this post explains in detail, it is generally impracticable for a self-funded ERISA-covered plan to...more

Sheppard Mullin Richter & Hampton LLP

DHHS Bolsters Non-Discrimination Protections for Recipients of Covered Health Care Services and Activities

Sheppard Mullin Richter & Hampton LLP on

In a Final Rule issued on May 6, 2024, the U.S. Department of Health and Human Services (“DHHS”) finalized regulations implementing Section 1557 of the Affordable Care Act (“Section 1557”). The Final Rule updates and...more

Seyfarth Shaw LLP

HHS Issues New Affordable Care Act Section 1557 Nondiscrimination Regulations

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Seyfarth Synopsis: New regulations effective August 6, 2024 restore and expand scope of civil rights protections under Section 1557 of the Affordable Care Act....more

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

Akerman LLP - HR Defense on

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

McDermott Will & Emery

HHS Final Section 1557 Nondiscrimination Regulations: Gender-Affirming Care and the Role of Carriers Under ASO Arrangements

McDermott Will & Emery on

On April 26, 2024, the US Department of Health and Human Services (HHS) issued a final rule (press release, fact sheet, FAQs) (final regulations) reinterpreting Section 1557 of the Affordable Care Act (ACA), which prohibits...more

McDermott Will & Emery

Ten Takeaways From Long-Awaited Section 1557 Nondiscrimination Protections

McDermott Will & Emery on

On April 26, 2024, the US Department of Health and Human Services (HHS) issued a final rule (press release, fact sheet, FAQs) reinterpreting Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the...more

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

Manatt, Phelps & Phillips, LLP

New York’s 1332 Waiver Extends Affordable Coverage to Additional Groups

Manatt, Phelps & Phillips, LLP on

On March 1, the Departments of Health and Human Services (HHS) and the Treasury approved New York’s section 1332 waiver that expands affordable coverage to additional groups of New Yorkers. The waiver essentially suspends New...more

Epstein Becker & Green

HHS Extends the Antidiscrimination Provisions of the Affordable Care Act to Patient Care Decision Support Tools, Including...

Epstein Becker & Green on

Turns out, ignorance really is bliss, at least according to the Office of Civil Rights (“OCR”) within the Department of Health and Human Services (“HHS”), in publishing its final rule on algorithmic discrimination by payers...more

Manatt, Phelps & Phillips, LLP

Emerging Opportunities for State-Based Marketplaces (SBMs)

Manatt, Phelps & Phillips, LLP on

The Affordable Care Act (ACA) Marketplaces have nearly tripled their enrollment in their first decade of operation, from eight million people in 2014 to 21.4 million in 2024. At the national level, the ACA has helped cut the...more

Rivkin Radler LLP

Federal Rules Limit “Junk” Health Plans

Rivkin Radler LLP on

On March 28, the U.S. Departments of Health and Human Services, Labor and the Treasury collectively issued final rules with respect to short-term and limited duration insurance (STLDI) plans in an effort to reduce healthcare...more

Brownstein Hyatt Farber Schreck

Biden Reveals Health Care Priorities in FY 2025 Budget

Brownstein Hyatt Farber Schreck on

On Monday, March 11, President Joe Biden unveiled his fiscal year (FY) 2025 budget request, the fourth of his presidency. The $7.3 trillion proposal calls for approximately $1.9 trillion in discretionary spending, $4.4...more

Epstein Becker & Green

Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in...

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Braidwood v. Becerra represents a significant legal challenge to the Affordable Care Act’s (ACA’s) preventive services coverage provision, which requires private health insurance to cover various clinical preventive services,...more

Epstein Becker & Green

CMS Announces New Primary and Behavioral Health Care Integration Demonstration Model

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On January 18th, the Centers for Medicare & Medicaid Services (CMS) announced a new demonstration model called the Innovation in Behavioral Health (IBH) Model, which is designed to improve outcomes for adults with mental...more

Ballard Spahr LLP

HHS Announces Temporary Copay Accumulator Non-Enforcement Policy

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The United States Department of Health and Human Services (HHS) has filed court pleadings stating that it does not intend to initiate enforcement actions against plans that maintain copay accumulator programs....more

Sheppard Mullin Richter & Hampton LLP

CMS Promotes Health Equity through Marketplace Standards and More in New Proposed Rule

Sheppard Mullin Richter & Hampton LLP on

On November 24, 2023, the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule to modify certain Patient Protection and Affordable Care Act (“ACA”)...more

McDermott+

McDermottPlus Check-Up: December 1, 2023

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CONGRESS - House Energy & Commerce Health Subcommittee Examines AI. The hearing explored the transformative potential of AI in healthcare, acknowledging its promise in enhancing efficiency, improving patient care and...more

McDermott Will & Emery

New Illinois Protections Against Patient Medical Debt May Also Help Reduce Hospital Bad Debt

McDermott Will & Emery on

Starting in mid-2024, Illinois hospitals will be required to take a much more active role in limiting consumers’ medical debt by screening all consenting uninsured patients for both public health insurance program coverage...more

Seyfarth Shaw LLP

IRS Releases 2024 Limits for Health and Welfare and Related Plans

Seyfarth Shaw LLP on

Seyfarth Synopsis: The IRS has announced an increase to the applicable dollar amount for determining the Patient-Centered Outcomes Research Institute (“PCORI”) Fee for 2024 as well as other health and welfare limits....more

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