Patient Protection and Affordable Care Act (PPACA) Healthcare Compliance

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

Midyear Check on Health Plan Compliance

If you sponsor or administer a group health plan, you are almost certainly taking steps to prepare for legal requirements that will become effective on or before January 1, 2015. New rules under HIPAA, the Affordable Care Act...more

Healthcare Ethics and Compliance Program Requirements

The Affordable Care Act included a mandate that medical service providers and suppliers enact compliance programs as a condition of participating in federal health care programs. (The ACA also set a deadline of March 23,...more

For ACA, Check Your Handbooks and Intranet

If you are like most employers, you have been diligently revising your benefits plans and working with your insurance providers to make sure your Summary Plan Descriptions comply with the Affordable Care Act. After those...more

Meaningful Compliance Equals Sound Financial Management

In traditional finance parlance the term "risk management" involves identifying events that can have adverse financial consequences and then taking action to prevent and/or minimize the damage caused by these events. Thus...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 30: The IRS Tells Us that Employer Payment Plans (Really,...

The IRS recently issued two Q&As on the subject of employer payment plans, the purpose of which was to again underscore that arrangements purporting to allow an employer to reimburse employees on a pre-tax basis for premiums...more

OIG Proposes Updates to Exclusion and CMP Authority

The Department of Health and Human Services, Office of Inspector General (OIG) recently issued a pair of proposed regulations to update its exclusion and civil monetary penalty (CMP) authority. The proposed regulations...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 31: ERISA Section 510 and Limiting Employee Hours

In last week’s post, we examined the appropriateness of capping the annual hours of new “variable hour employees” as a way to limit exposure under the Affordable Care Act’s employer shared responsibility rules. (These rules...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 32: Why Capping Annual Hours at 1560 Does Not Work

Whenever Congress draws a line in the sand—such as with exposure for assessable payments under the Affordable Care Act’s employer shared responsibly rules—entities subject to regulation (here, applicable large employers) will...more

HHS OIG Releases Proposed Rules Regarding Increased Authority to Combat Fraud and Abuse under the ACA

The Office of Inspector General (OIG) of the Department of Health and Human Services proposed two new rules last week in order to expand its enforcement authority, implementing changes adopted as part of the Patient...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 36: Hacking the Affordable Care Act’s $100/Day Penalties for...

Particularly with the issuance of final regulations under the Affordable Care Act’s employer shared responsibility rules, employers have been concerned—justifiably—with the pay-or-play penalties. ...more

Compliance Checkup: Does Your Company’s Retiree Medical Coverage Get a Passing Grade?

Does your company offer retiree medical coverage? This article highlights some of the common legal compliance issues we’ve noted recently when reviewing post-retirement medical coverage, and provides recommendations for...more

Final Regulations Issued Regarding Employer Reporting Requirements Under ACA

Recently issued final regulations on the employer reporting requirements under the Affordable Care Act (ACA) clarify and streamline the process for reporting information relating to the provision of minimum essential coverage...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 42: Treasury Department and IRS Issue Final Reporting Rules...

On March 5th, 2014, the Treasury Department and the IRS issued two final reporting rules of critical importance to employers...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 43: Coordinating the 3-Month Delay under Employer Shared...

So much attention has been paid to the issuance of the final employer shared responsibility regulations that some might have missed the news that final regulations were recently issued under another of the Affordable Care...more

Small Employer Coverage Under the Affordable Care Act

The Affordable Care Act (ACA) does not require small employers to offer health coverage to their employees. If coverage is offered, however, the coverage must meet ACA requirements. The only exception is for grandfathered...more

U.S. Privacy and Data Protection: 2013 Year in Review and a Look Ahead to 2014

In Boston, we celebrated Data Privacy Day (January 28) by presenting “U.S. Privacy and Data Protection: 2013 Year In Review and a Prediction of What’s to Come in 2014” for participants in an IAPP KnowledgeNet. Our panel of...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 49: Waiting for the Final Code Section 4980H Regulations

So where are they? Final regulations implementing the Affordable Care Act’s rules governing shared responsibility of employers were widely expected to have “dropped” before the beginning, or perhaps during the first...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 51: Speculating about Code Section 4980H Transitional Relief

(Note: This is the first installment of a series of entries that Alden will be posting each week for the next 51 weeks as he counts down to the January 1st, 2015 ACA pay-or-play deadline). ...more

Changing Healthcare Landscape Poses Challenges for Directors

Despite the continuing legal challenges and political hardball, as well as the delays and technical glitches, it appears that the Patient Protection and Affordable Care Act, more commonly known as Obamacare, is here to stay. ...more

ACA Update: Who Will Staffing Firms Have to Cover Starting Jan. 1, 2015?

The Obama administration's July 2013 announcement, delaying enforcement of the employer mandate under the Affordable Care Act by one year, has affected not only when employees must be offered health insurance coverage but...more

Retail Industry Update, No. 4, December 2013: New Year's Resolutions: Five Areas Of Focus For 2014

The Affordable Care Act has dominated the headlines of employment newsletters (justifiably) for the last six months. It will continue to be an area of focus for all employers. But don’t lose sight of the fact that all the...more

Labor Letter, December 2013: Was It A Good Year Or Bad Year? The 2013 Employment Law Year In Review

It's pretty common each December to take stock and look back at the year that is ending, whether it’s recounting the happy times and counting one’s blessings, or reliving the disappointments and ruing over the regrets (and...more

Data Collection Under The Sunshine Act

Data collection requirements under the Physician Payment Sunshine Act commenced August 1, 2013. This provision of the Patient Protection and Affordable Care Act and the corresponding regulations require an entity that is...more

Carrot Or Stick? When Does A Voluntary Wellness Program Become Involuntary?

Employer wellness programs, which are designed to stem rising health care costs by encouraging healthy behaviors among employees, are rising in popularity. Such programs will receive another boost when certain provisions of...more

IRS Proposes Rules Regarding Information Reporting Requirements Under Sections 6055 and 6056 of the Affordable Care Act

Starting in 2014, the Affordable Care Act requires that nonexempt individuals either maintain “minimum essential coverage” or pay an individual payment with their income tax returns. Minimum essential coverage may be...more

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