News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) › Qualified Health Plans

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 -
Warner Norcross + Judd

IRS Increases Benefit Plan Limits for 2024

Warner Norcross + Judd on

The IRS has announced increased annual limits for retirement and other benefit plans for 2024. While the increases for 2024 are smaller than we’ve seen in prior years, they still may have a significant impact on plans and...more

King & Spalding

HHS Releases Notice of Benefit and Payment Parameters 2023 Proposed Rule

King & Spalding on

On December 28, 2021, HHS released a proposed rule governing plans issued in the Patient Protection and Affordable Care Act (ACA) marketplaces beginning with the 2023 plan year (the Proposed Rule). Among other changes to the...more

Bradley Arant Boult Cummings LLP

Rule Providing Relief for Grandfathered Health Plans Finalized

Bradley Arant Boult Cummings LLP on

The Departments of Labor (DOL) and Health and Human Services (HHS) and the Treasury have finalized a rule for grandfathered group health plans under the Affordable Care Act (ACA) without making any substantive changes from...more

King & Spalding

Health Plan Responsibility to Pay for Hospital Inpatient Care When Members Await Placement at Post-Acute Facilities

King & Spalding on

Hospitals that attempt to discharge a patient to a post-acute level of care but are not able to because they cannot find an appropriate accepting facility must continue providing care if the patient cannot be safely...more

Littler

“Medical Necessity” Isn’t Well-Defined Unless It Is Well-Defined

Littler on

A U.S. District Court in Connecticut recently issued an order that highlights the importance of understanding exactly what the term “medically necessary” means in an ERISA health plan....more

Manatt, Phelps & Phillips, LLP

Risk Corridors Program Update: Key Legal Actions and Decisions

Manatt, Phelps & Phillips, LLP on

Editor’s Note: The article below provides an update on the risk corridors program (Program) created by the Patient Protection and Affordable Care Act (ACA). The Program was intended to encourage qualified health plan (QHP)...more

Hogan Lovells

CMS releases annual health insurance exchanges final rule

Hogan Lovells on

On 18 April 2019 the Centers for Medicare & Medicaid Services (CMS) released the Notice of Benefit and Payment Parameters final rule for 2020 (2020 Payment Notice) applicable to qualified health plans (QHPs) offered on health...more

Manatt, Phelps & Phillips, LLP

CMS Promotes New 1332 Waiver Models, States Weigh Options

Manatt, Phelps & Phillips, LLP on

With a divided Congress that will struggle to reach agreement about major health policy legislation, states will continue to serve as the drivers and testing ground for new healthcare reforms in at least the next two years....more

Sheppard Mullin Richter & Hampton LLP

The Risk Corridor is Closed: Insurers Seek Recourse in the Federal Circuit

Sheppard Mullin Richter & Hampton LLP on

On July 30, 2018, two insurers – Moda Health Plan, Inc. (“Moda”) and Land of Lincoln Mutual Health Insurance Company – petitioned the U.S. Court of Appeals for the Federal Circuit to reconsider the Court’s June 14, 2018...more

Manatt, Phelps & Phillips, LLP

Healthcare Litigation - April 2018

Manatt, Phelps & Phillips, LLP on

Mental Health and Minors: Proceed With Caution! - Imagine representing a party in a lawsuit concerning coverage for mental health services. The lawsuit was brought by the parents of a minor child. The client received a...more

Hogan Lovells

CMS releases annual health insurance exchanges final rule

Hogan Lovells on

On April 9, 2018, the Centers for Medicare & Medicaid Services (CMS) released the Benefit and Payment Parameters final rule for 2019 (2019 Payment Notice) applicable to qualified health plans (QHPs) offered on health...more

Faegre Drinker Biddle & Reath LLP

ACA Risk Corridors Update: Trump Administration Releases 2016 Amounts, Paving the Way for Litigation Over Amounts Owed

Faegre Drinker Biddle & Reath LLP on

On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its Risk Corridors payment and charge amounts for the 2016 benefit year. This event is significant in that it both acknowledges and quantifies...more

Carlton Fields

Humana Bundles Up; Files Suit To Recover Hundreds Of Millions In Risk Corridor Payments From Uncle Sam

Carlton Fields on

On November 2, Humana filed a lawsuit in the United States Court of Federal Claims to recover approximately $600 million allegedly owed by the United States government. See Humana Inc. v. U.S., case number 1:17-cv-01664. ...more

Faegre Drinker Biddle & Reath LLP

A Step Toward ‘Replace' Without the ‘Repeal': The Trump Administration Re-Regulates Obamacare

Faegre Drinker Biddle & Reath LLP on

On Friday, October 27, the Centers for Medicare and Medicaid Services (CMS) published its draft annual Proposed Notice of Benefits and Payment Parameters for Calendar Year 2019. This proposal follows on the heels of a Request...more

Faegre Drinker Biddle & Reath LLP

CSR Litigation Update: California Court Denies States' Motion for Preliminary Injunction – What Does This Mean for Health...

Faegre Drinker Biddle & Reath LLP on

On October 25, 2017, in the case State of California v. Trump, the U.S. District Court for the Northern District of California denied a motion brought by 17 states seeking to order the Trump administration to resume...more

Faegre Drinker Biddle & Reath LLP

What Can Health Plans Do if the Trump Administration Stops Making CSR Payments?

Faegre Drinker Biddle & Reath LLP on

Amid assertions that the Affordable Care Act (ACA) should be allowed to fail, the Trump administration has indicated that it may stop paying subsidies that are central to ACA markets. At the core of these subsidies are...more

Polsinelli

Laws and Regulations Affecting Government Contractors

Polsinelli on

How Trump’s “Buy American and Hire American” Could Alter Procurements - The President’s “Buy American and Hire American” Executive Order (EO), issued April 18, 2017, reflects Executive Branch policy and orders several...more

McDermott Will & Emery

CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions

McDermott Will & Emery on

CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified...more

Nossaman LLP

Stable or Fable: Will the Trump Administration Proposed Rule Save the Exchanges or Hasten Their Demise?

Nossaman LLP on

A proposed rule intended to stabilize the individual and small group insurance markets was issued on February 17, 2017, only a week after the Senate confirmed Tom Price as the Secretary of the U.S. Health and Human Services...more

King & Spalding

CMS Issues Proposed Changes to ACA Healthcare Exchanges

King & Spalding on

On February 15, 2017, CMS issued a proposed rule which the Trump administration contends will reform and stabilize the individual and small group health insurance market exchanges created pursuant to the Affordable Care Act...more

McDermott Will & Emery

Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain

McDermott Will & Emery on

In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a...more

Faegre Drinker Biddle & Reath LLP

President Trump Props Up the ACA: A Summary of the New Administration's ACA Market Stabilization Regulation

Faegre Drinker Biddle & Reath LLP on

On February 15, President Trump and new Department of Health and Human Services (HHS) Secretary Tom Price released their first proposed regulations addressing the Affordable Care Act (ACA). While remaining committed to...more

Downs Rachlin Martin PLLC

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017

Downs Rachlin Martin PLLC on

The Agency of Transportation has submitted a proposal to the House Transportation Committee that would allow the agency to seek damages from a utility that fails to move or adjust a utility line that is in a state or local...more

Faegre Drinker Biddle & Reath LLP

Another Challenge to U.S. on Risk Corridor Payments

Faegre Drinker Biddle & Reath LLP on

Molina Healthcare has joined the long line of insurers suing the government for failure to honor its obligations under the Affordable Care Act’s “risk corridor” program. According to Molina’s 84-page complaint filed Jan. 23,...more

Foley & Lardner LLP

Hawai’i Receives Approval for the First State Innovation (Section 1332) Waiver

Foley & Lardner LLP on

The federal Department of Health and Human Services and Department of Treasury (the Departments) agreed that certain small employer health insurance coverage provisions of the Affordable Care Act (ACA) would be waived for the...more

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