News & Analysis as of

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

Groom Law Group, Chartered

Latest Update to the Ongoing Challenge to the ACA’s Preventive Services Mandate

On June 21, 2024, the United States Court of Appeals for the Fifth Circuit (“Fifth Circuit”) issued its ruling in Braidwood v. Becerra. The court determined that the Affordable Care Act’s (“ACA”) requirement that group...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

ACA-Required Coverage of Contraceptive Care Remains Agency Focus

Once again, the U.S. Departments of Labor, Health and Human Services, and the Treasury have issued guidance on the Affordable Care Act’s (ACA) required coverage of contraception without cost sharing, clarifying the permitted...more

Ballard Spahr LLP

Prescription for Chaos: Copay Accumulator Programs Called Into Question

Ballard Spahr LLP on

Summary - Employers taking advantage of copay accumulator programs now face unexpected administrative complications following a recent federal court decision....more

Ballard Spahr LLP

Meet Me at the Corner of No Surprises and …

Ballard Spahr LLP on

Summary - The Departments of Labor, Health and Human Services, and the Treasury have issued guidance that coordinates application of the No Surprise Billing rules under the Consolidated Appropriations Act, 2021, with the...more

Proskauer - Employee Benefits & Executive...

Fifth Circuit Stay Means Preventive Services Mandate Remains in Effect

On Tuesday, the U.S. Court of Appeals for the Fifth Circuit approved the parties’ stipulated agreement to stay enforcement of the district court decision in Braidwood Management Inc. v. Becerra until the appeal is resolved...more

Sheppard Mullin Richter & Hampton LLP

Navigating the Wild West of the New ACA Preventative Care Ruling

On March 30, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a decision in Braidwood Management Inc. v. Becerra (“Braidwood”), invalidating the Affordable Care Act’s (“ACA’s”) mandate...more

Dickinson Wright

Federal Court Blocks Enforcement of Some ACA Preventive Health Service Requirements: What Plan Sponsors Should Consider

Dickinson Wright on

In a March 2023 ruling, a Texas federal district court vacated all actions taken by the Departments of Labor (“DOL”), Health and Human Services (“HHS”), and Treasury (collectively, the “Departments”) to implement or enforce...more

Bradley Arant Boult Cummings LLP

Departments Issue Guidance on Preventive Services under the ACA Following the Braidwood Decision

In light of the March 30 Braidwood Mgmt. Inc. v. Becerra decision, the Department of Labor, Department of Health and Human Services, and Department of the Treasury (the “departments”) have issued FAQ guidance on how the...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Federal District Court’s Ruling on Affordable Care Act Preventive Care Eases Employer Burden—at Least for Now

Employers, at least for now, may have some relief from some of the Affordable Care Act (ACA) requirements to cover preventive care services without cost sharing under a nationwide injunction issued March 30, 2023, by a...more

McDermott Will & Emery

Tri-Agencies Address Preventive Services Coverage in the Wake of Braidwood

McDermott Will & Emery on

In response to Braidwood Mgmt. Inc. v. Becerra, a recent case striking down part of the Affordable Care Act (ACA) preventive services mandate, the US Departments of Labor, Health and Human Services, and the Treasury...more

Groom Law Group, Chartered

ACA Preventive Service Requirements Partially Vacated

On March 30, 2023, the District Court for the Northern District of Texas issued an opinion and order in Braidwood Mgmt. Inc. v. Becerra that vacates the implementation and enforcement of certain preventive service provisions...more

Snell & Wilmer

Departments Clarify that HIV PrEP Services Must Be Free by September 17

Snell & Wilmer on

Back in June of 2019, the United States Preventive Services Task Force (“USPSTF”) released an A-rated recommendation for HIV Preexposure Prophylaxis (“PrEP”). As a result, the Affordable Care Act’s preventive care rules...more

McGuireWoods Consulting

The Courts and Healthcare Policy - August 2021

The courts continue to play an important role in health policy. 2020 saw several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

Jackson Walker

Guidance Reminds Health Plans to Check Up on Preventive Care Compliance

Jackson Walker on

On July 19, 2021, the Internal Revenue Service, U.S. Department of Labor, and the U.S. Department of Health and Human Services (the “Tri-Agencies”) issued new frequently asked questions (FAQs) regarding the implementation of...more

Husch Blackwell LLP

Federal Guidance On Balance Billing: The No Surprises Act And Its Interim Final Rule: Part I

Husch Blackwell LLP on

On July 1, 2021, the Office of Personnel Management (“OPM”), the Internal Revenue Service (“IRS”), the Department of Treasury (“Treasury”), the Employee Benefits Security Administration (“EBSA”), the Department of Labor...more

McGuireWoods Consulting

The Courts and Healthcare Policy - July 2021

2020 saw the courts continuing to play an important role in health policy with several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

McGuireWoods Consulting

The Courts and Healthcare Policy - June 2021

2020 saw the courts continuing to play an important role in health policy with several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

McGuireWoods Consulting

The Courts and Healthcare Policy - April 2021

2020 saw the courts continuing to play an important role in health policy with several notable lawsuits related to the Affordable Care Act (ACA). Several other Trump administration policies were challenged, including Medicare...more

McGuireWoods LLP

Update: House Passes, President to Sign American Rescue Plan With Senate Healthcare Provisions

McGuireWoods LLP on

On March 10, 2021, the U.S. House of Representatives narrowly passed H.R. 1319, the American Rescue Plan Act of 2021, on a largely partisan basis by a 220-211 vote. Final passage came four days after the U.S. Senate amended...more

Manatt, Phelps & Phillips, LLP

Oregon Public Option Report: An Evaluation and Comparison of Proposed Delivery Models

Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of...more

Kelley Drye & Warren LLP

Health Care Reform Changes and Other Updates

This Advisory provides a summary of recent developments impacting Affordable Care Act (“ACA”) requirements applicable to employers, as well as other recent changes impacting employer-sponsored health plans. ACA...more

Faegre Drinker Biddle & Reath LLP

Federal Circuit Holds U.S. Liable to Health Insurers for ACA Cost-Sharing Reductions

Cost-Sharing Reduction (CSR) Payments Take Effect. Under Section 1402, the Affordable Care Act (ACA) implements a plan for reducing the amount of out-of-pocket costs, such as deductibles and co-payments, that lower-income...more

Faegre Drinker Biddle & Reath LLP

Considerations for Entry or Reentry Into the Individual Health Insurance Market

Many health insurers and HMOs may be considering entering or reentering the individual health insurance market, either on or off a federal or state-based health insurance marketplace. Over the last two years, the individual...more

Manatt, Phelps & Phillips, LLP

[Webinar] COVID-19: The Road Ahead for Commercial Health Insurance - April 23rd, 2:00 pm - 3:00 pm ET

Examine the Evolving Challenges That Lie Ahead for Healthcare Stakeholders and State Regulators—and What You Can Do Now to Prepare and Protect Your Organization—at a New Manatt Webinar. Effective health insurance...more

Pullman & Comley - Labor, Employment and...

CMS FAQ re Essential Health Coverage and the Coronavirus (COVID-19)

On March 12, 2020, the Center for Medicare & Medicaid Services Center for Consumer Information & Insurance Oversight issued an FAQ regarding coverage for diagnosis and treatment of COVID-19 under the Affordable Care Act. CMS...more

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