News & Analysis as of

Manatt on Health Reform: Weekly Highlights: November 2014 #4

In this week’s highlights, new proposed guidance from the feds would allow default renewals to lower cost plans and bring enhanced transparency to Qualified Health Plan rate increases; open Enrollment hits its stride –...more

Health Care Update - November 2014 #3

In This Issue: - 21st Century Cures Remains Top Bi-Partisan Priority for 2015 - Senate Passes Critical Access Hospital Direct Supervision Bill - Implementation of the Affordable Care Act - Other...more

Health Care Reform Implementation Update

Looming midterm elections have made the past several months difficult for Democrats and Republicans alike when it comes to the Affordable Care Act. With most of the midterm elections now wrapped up, lawmakers can turn their...more

Manatt on Health Reform: Weekly Highlights

Welcome to the first publication of the “Manatt on Health Reform: Weekly Highlights” newsletter. Many of you are familiar with the healthcare reform tracking efforts and weekly newsletters we produced for the KidsWell...more

Late Push to Reauthorize CHIP Funding This Session

Approximately eight million children currently covered by the Children’s Health Insurance Program (CHIP) may lose access to their pediatric-specific benefits and provider networks if legislation is not passed to extend...more

Manatt on Medicaid: The Emerging Conversation About the Future of CHIP

During passage of the Affordable Care Act (ACA), a debate erupted over the future of the Children’s Health Insurance Program (CHIP), a well-established program that now offers coverage to 8 million children in low- and...more

Medicaid Enrollment Continues to Grow

The U.S. Department of Health and Human Services (HHS) has reported that at the close of April, an additional 6 million Americans have enrolled in Medicaid and related health programs for the poor since the launch of coverage...more

Health Care Reform Implementation Update - April 21, 2014

On April 14, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) reported their findings that show a smaller rise in insurance premium costs under the Affordable Care Act (ACA) than previously...more

Manatt on Medicaid: The Numbers

Even as the news media tries to untangle the latest data on Marketplace enrollment, an equally important and still-evolving story is playing out on the Medicaid side of the open enrollment equation. According to a Centers for...more

Health Care Reform Implementation Update - April 2014

Last Thursday Kathleen Sebelius resigned from her post as Secretary of Health and Human Services (HHS). On Friday President Obama nominated Sylvia Matthews Burwell, the Office of Management and Budget (OMB) Director. As...more

What Immigrants Need to Know about Health Insurance

America is home to more than 21 million non-citizen immigrants, according to Kaiser Health News, and for many of these immigrants, health coverage is a top concern. Given that the health care landscape has undergone...more

CMS Releases Long-Awaited Details for Sunshine Act Compliance

The Physician Payment Sunshine Act (the "Act") was enacted as part of the Patient Protection and Affordable Care Act for the purpose of promoting transparency between the medical industry and health care providers. It...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

Immigrants and the Affordable Care Act

There are many questions surrounding the Affordable Care Act (“ACA” or the “Act”), and one common question is how it affects immigrants. Naturalized citizens are treated exactly like U.S. born citizens under the Act, and...more

Health Care Reform Implementation Update - August 12, 2013

The House Energy and Commerce Committee voted unanimously on legislation that would repeal the sustainable growth rate (SGR) formula that has historically led to annual decreases in physician payments that are fixed at the...more

Client News Alert: Regarding Physician Payments Sunshine Act

On August 1, 2013 a new reporting obligation under the federal Physician Payments Sunshine Act (“Sunshine Act”) takes effect. The Sunshine Act was originally signed into law on March 23, 2010, as part of the Patient...more

CMS Issues Final Rule on Medicaid and Children’s Health Insurance Program Eligibility Provisions, Appeals, and Related...

On July 5, 2013, CMS issued a final rule supplementing the Exchange final rule, reflecting new statutory eligibility provisions and implementing changes related to Medicaid and the Children’s Health Insurance Program (CHIP)...more

Health Care Reform Implementation Update - July 16, 2013

Capitol Hill and the agencies went back and forth last week on the impact and consideration involved in delaying the Affordable Care Act’s (ACA) employer mandate; votes in the House are expected this week on it, as well as a...more

Coverage Alternatives for Low and Modest Income Consumers

The Patient Protection and Affordable Care Act (ACA) describes a continuum of subsidized coverage for individuals with incomes below 400 percent of the Federal Poverty Level (FPL): Medicaid, the Children’s Health Insurance...more

Simplified, Real-Time Verification Issue Brief

The Affordable Care Act (ACA) requires a coordinated and streamlined eligibility and enrollment process for all Insurance Affordability Programs (IAPs), including Medicaid, the Children’s Health Insurance Plan (CHIP), and...more

CMS Announces $1 Billion in Funding for Innovation Grants

On May 15, 2013, CMS released a funding opportunity announcement for round two of the Health Care Innovation Awards. The grants are administered by the CMS Innovation Center, which is authorized by the Affordable Care Act to...more

Health Care Reform Implementation Update - May 6, 2013

Last week the Centers for Medicare & Medicaid Services (CMS) issued new proposed regulations on FY 2014 payment updates and regulatory policy changes for inpatient and long term care hospitals, skilled nursing facilitates,...more

CMS Issues Final Rule for Implementing Sunshine Act

On February 8, 2013, 16 months after the statutory deadline, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register the final regulation implementing the physician payment transparency...more

New Guidance Addresses Individual Shared Responsibility Payments and Premium Tax Credits

The IRS and the U.S. Department of Health and Human Services (HHS) have issued two important pieces of guidance under the Patient Protection and Affordable Care Act regarding the responsibilities imposed on individuals to...more

Health Care Reform Implementation Update - February 4, 2013

Several agency actions on the Affordable Care Act out of HHS and Treasury last week include proposed regulations detailing exemptions from the shared responsibility tax, such as an exemption for those who would qualify for...more

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