News & Analysis as of

Why Providers Should Think About the Impact of ICD-10 on Managed Care Reimbursement Now

ICD-10 implementation has been delayed by Medicare until October 2015. Many believe it may be delayed again and are putting off thinking about its impact until it is clear that the updated code set will be implemented by...more

One Last Shot at Meeting October Deadline on Two-Midnight Appeals

On October 27, 2014, the Centers for Medicare & Medicaid Services (CMS) made a concession—a very small one—to hospitals racing against the looming October 31, 2014, deadline for accepting the offer of 68 cents on the dollar...more

Deadline November 5 For Large Self-Insured Health Plans To Obtain Health Plan Identifier

Regulations issued by the Department of Health and Human Services (“HHS”) pursuant to the Affordable Care Act require certain health plans to obtain a Health Plan Identifier (an “HPID”) by November 5, 2014. The HPID is a...more

Deadline for Obtaining Health Plan Identifier Quickly Approaching

Health Care Reform requires most self-funded and fully-insured group health plans to obtain a Health Plan Identifier (HPID). The HPID is a 10-digit number that will be used to identify the plan in covered electronic HIPAA...more

Health Law Alert: CMS Modifications to Meaningful Use Rule Gives Providers a Welcome Reprieve

On September 4, the Centers for Medicare & Medicaid Services (CMS) published a Final Rule that made several helpful changes to the meaningful use requirements for the Electronic Health Record (EHR) Incentive Program. Among...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 16: So What, Exactly, is an “Offer of Coverage”?

Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more

Don't Delay: Deadline for ICD-10 Compliance for October 1, 2015 Still Underway

In a final rule released on July 31, the U.S. Department of Health and Human Services (HHS) confirmed October 1, 2015 as the compliance date for health care providers, health plans, and health care clearinghouses to...more

ICD-10 Compliance Deadline Is Now October 1, 2015

Health care providers, health plans, and health care clearinghouses (“Health Care Entities”) are required to comply with ICD-10 (which stands for the International Classification for Diseases, 10th Edition) on October 1,...more

As Sunshine Act Reporting Deadline Looms, CMS Issues Additional Guidance

With the June 30 deadline for Phase 2 Sunshine Act reports by pharmaceutical and medical device manufacturers (“Applicable Manufacturers”) and group purchasing organizations (“GPOs’) quickly approaching, the Centers for...more

Applicable Manufacturers Face June 30th Deadline for Sunshine Act Reporting

CMS will begin to enforce what could be significant penalties on manufacturers who fail to report required data. The Centers for Medicare & Medicaid Services (CMS) has announced a short timeframe before detailed...more

There’s a Code for That: Counting Down to ICD-10 and a Poem to Help You Remember!

On October 1, 2014, all HIPAA-covered persons and entities must be compliant with the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM and ICD-10-PCS,...more

Another Tax Trap: Imputed Income in Divorce Settlements, Part 1

April 15th is creeping up on us. I find doing my taxes while its snowing, AGAIN, a real insult. This week and next week’s post were written by my terrific colleagues, Ron Barriere and Jen Green. They highlight a tricky...more

ICD-10 Compliance Deadline is October 1, 2014—Philadelphia Office of CMS to Offer Webinars to Ease Transition

ICD-9 diagnosis and inpatient procedure codes will make way for ICD-10 codes starting October 1, 2014. Health care entities and providers need to be ready to make the switch if they want to receive reimbursement for claims....more

OIG and CMS Extend Expiration Date for EHR Donations

As the final days of 2013 passed and the sunset of the Stark Law exception and anti-kickback law safe harbor for electronic health record (EHR) donations loomed nearer, the U.S. Department of Health and Human Services (HHS)...more

Deadline to Enroll in Health Insurance Coverage Extended through December 24

Along with stocking stuffers and gifts, last-minute Christmas shoppers have another item to put on their list: another chance to purchase health insurance coverage through the Federal Insurance Exchange. The Obama...more

Employee Benefits Update: 2013 Year End Plan Tasks

As we approach the end of the year, employers and plan sponsors of qualified retirement plans and health and welfare plans should take time to meet various upcoming deadlines. Failure to comply with the deadlines may result...more

HIPAA Omnibus Rule Compliance Deadline

September 23, 2013, the deadline for compliance with the new Health Insurance Portability and Accountability Act (HIPAA) regulations, is here. Although there has been much discussion about the new regulations since they were...more

Affordable Care Act Mandates Employer Notice of Coverage Options to Employees by October 1, 2013

Pursuant to the Affordable Care Act (ACA), individuals and employees of small businesses will be able to access health insurance coverage through a private health insurance market – the Health Insurance Marketplace –...more

Notice Regarding Marketplace Coverage Options Due October 1

The October 1, 2013 deadline for providing employees with a notice of their coverage options through the newly established public health insurance exchanges (referred to as the “Marketplace”) is quickly approaching. This news...more

REMINDER: Oct. 1 Deadline for ACA Marketplace Notice Approaching

All employers, except for the relative few that are not subject to the Fair Labor Standards Act (FLSA), are required to provide a written Notice to their employees regarding the coverage options available under the federal...more

Exchange Notices Under the Affordable Care Act

What you need to know: Employers must distribute notices of public exchange coverage to employees by October 1, 2013 to ensure compliance with the Patient Protection and Affordable Care Act. ...more

Notice to Employees About Health Insurance Exchanges Due October 1, 2013

The Affordable Care Act provides individuals with the option of purchasing health coverage through new health insurance exchanges, or “Marketplaces” that will operate in every state effective January 1, 2014 (e.g.,...more

The HIPAA Compliance Deadline is Less Than One Week Away. Business Associate Agreements and Other Documents Must Be Revised. Are...

On September 23, 2013, Covered Entities and Business Associates must be compliant with the final Health Insurance Portability and Accountability Act (HIPAA) Omnibus Rule (the “HIPAA Final Rule”). The HIPAA Final Rule modified...more

What Do Employers Need to Know About the ACA Marketplace Notices?

Although the Affordable Care Act's (ACA) "employer mandate" has been delayed until 2015, health insurance exchanges are still scheduled to start offering health coverage to individuals and employees of small businesses...more

Employment Law Alert - September 2013: The Affordable Care Act - October 1, 2013 Notice Requirement for Employers

Beginning January 1, 2014, individuals and employees of small businesses will have access to affordable coverage through a new competitive private health insurance market – the Health Insurance Marketplace. The...more

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