News & Analysis as of

Cost-Sharing Patient Protection and Affordable Care Act (PPACA)

The Fate of the ACA’s Cost-Sharing Reduction Subsidies

by Perkins Coie on

As deliberations over a replacement of the Affordable Care Act (ACA) continue in the U.S. House of Representatives, the fate of the ACA’s Cost-Sharing Reduction subsidies (CSRs) may be at stake. Under the ACA, Marketplace...more

HHS Finalizes Health Insurance Market Stabilization Rules

by Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) has finalized regulations designed to help stabilize the individual and small group health insurance markets and, in particular, the health insurance exchanges...more

What’s New in Washington: 10 Things You Need to Know

Congress entered into its spring recess on April 7 having delivered regulatory reforms to President Trump’s desk. In the first 75 days of the Trump administration, legislators approved 13 Congressional Review Act resolutions,...more

ACA Repeal and Replace Plan is Released

by Ballard Spahr LLP on

The House Ways and Means and Energy and Commerce Committees have released, in two parts, budget reconciliation legislation, the first steps of Congress' proposal to "repeal and replace" the Affordable Care Act. Reconciliation...more

Entitlement Reform – Medicaid

by Baker Donelson on

Of particular focus in the coming year will be Medicaid, the federal/state health care program for low-income Americans. The program, which cost the federal government $334 billion in FY15, is a frequent target of...more

Manatt on Health Reform: Weekly Highlights - February 2017 #3

Congress moves forward on key healthcare appointments; the Administration takes steps to shore up the Marketplaces; and Governors prepare to gather in Washington as new reports document the ACA's impacts on states....more

Manatt on Health Reform: Weekly Highlights - January 2017 #4

The National Governors Association and National Association of Insurance Commissioners weigh in on ACA repeal and replace; CBO releases new Medicaid and Marketplace enrollment estimates; and Massachusetts proposes reinstating...more

New Year, New Resolutions, New Safe Harbors

by Akerman LLP on

As we welcome the new year and its endless possibilities, we also welcome some new Anti-Kickback Statute safe harbors and concomitant business possibilities. In December, the U.S. Department of Health and Human Services...more

Comparison of Key Repeal and Replace Proposals

As the incoming Congress and administration develop plans to “repeal and replace” the Affordable Care Act (ACA), analysis of five earlier repeal and replace proposals provides insights into the key features likely to appear...more

OIG Revises Safe Harbors under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

by McDermott Will & Emery on

On December 7, 2016, the Office of Inspector General of the US Department of Health and Human Services published a final rule containing revisions to both the federal Anti-Kickback Statute safe harbors and the beneficiary...more

On Hold: House v. Burwell

by Freeborn & Peters LLP on

In a brief Order issued on December 5, 2016, in U.S. House of Representatives v. Burwell, the U.S. Court of Appeals for the D.C. Circuit granted the motion filed by the U.S. House of Representatives (House) seeking to put the...more

Cost-Sharing Subsidies Ruling Adds More Uncertainty to Affordable Care Act

by Holland & Knight LLP on

Holland & Knight issued an alert in May 2016 regarding litigation by the U.S. House of Representatives against the Obama Administration and the decision of the U.S. District Court for the District of Columbia enjoining any...more

House Files Motion to Delay Affordable Care Act Suit in Light of Change in Administration

by King & Spalding on

On November 21, 2016, the U.S. House of Representatives filed a motion with the D.C. Court of Appeals requesting a temporary hold on briefing in U.S. House of Representatives v. Burwell as a result of Donald Trump’s election...more

House v. Burwell: The Obama Administration’s Final Brief?

by Freeborn & Peters LLP on

The Department of Justice (DOJ) has filed its response to the motion filed on behalf of the U.S. House of Representatives (House) seeking to put the lawsuit challenging the Affordable Care Act’s (ACA’s) cost-sharing subsidies...more

House v. Burwell: Now or Never?

by Freeborn & Peters LLP on

Attorneys for the United States House of Representatives (House), in U.S. House of Representatives v. Burwell, the case challenging certain cost-sharing subsidies in the Affordable Care Act (ACA), filed a motion asking the...more

OSHA Issues Final Rule On Complaints Under Affordable Care Act's Anti-Retaliation Provision

by Holland & Knight LLP on

The Affordable Care Act (ACA) added Section 18C to the Fair Labor Standards Act (FLSA) to prohibit retaliation against employees who engage in certain activities protected by the ACA. Responsibility for receiving and...more

Manatt on Health Reform: Weekly Highlights - August 2016 #5

A federal report finds that Marketplace premiums are lower in expansion states; Massachusetts and Pennsylvania launch prescription drug monitoring systems; and Kentucky submits a slightly modified Medicaid expansion waiver to...more

Recent Congressional Hearings

by Reed Smith on

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

Employee Benefits Developments - May 2016

by Hodgson Russ LLP on

Agencies Issue New FAQs on the Affordable Care Act.The Departments of Labor, Health and Human Services, and the Treasury (the agencies) issued another set of frequently asked questions (FAQs) regarding the implementation of...more

Federal Court Strikes Down ACA Cost Sharing Reduction Payments

by McDermott Will & Emery on

In Depth - A federal district court judge in Washington, DC ruled on May 12, 2016, that Congress did not appropriate funds for the Affordable Care Act’s (ACA) cost-sharing reduction (CSR) subsidies. See United States...more

Court Finds Faulty Funding Provisions in Affordable Care Act Affect Low-Income Affordability Provisions

On Thursday, May 12, 2016, a federal district court judge ruled against the Obama administration, finding that no appropriations have been made to fund payments under Section 1402 of the Affordable Care Act to reimburse...more

Judge rules HHS can't pay cost-sharing subsidies to QHPs, but allows funding to continue

by Dentons on

More than six years after the Affordable Care Act (ACA) was enacted, legal challenges continue to thread their way through the judicial system. In a May 12, 2016 decision, US District Court Judge Rosemary M. Collyer, an...more

U.S. House of Representatives v. Burwell: A Failure to Appropriate, Not a Failure in Drafting

by BakerHostetler on

“A most curious and convoluted argument whose mother was undoubtedly necessity,” wrote Judge Rosemary M. Collyer in describing the argument made by the U.S. Department of Health and Human Services (HHS) to uphold the...more

House Republicans Win Challenge to ACA Cost-Sharing Subsidies

by King & Spalding on

On May 12, 2016, the U.S. District Court in Washington, D.C. ruled in favor of House Republicans, concluding that the government wrongly spent billions reimbursing insurance companies for providing discounted health coverage...more

Court Sides with House of Representatives in ACA Cost-Sharing Subsidy Challenge

by Freeborn & Peters LLP on

In a suit brought by the U.S. House of Representatives challenging the administration’s implementation of the Affordable Care Act (ACA), a federal district court for the District of Columbia ruled in a major decision that the...more

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