Health Insurance

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Weekly Update Newsletter - January 2015 #2

GOVERNMENT CONTRACTS - HHS IG Issues Report Regarding Federal Marketplace: Inadequacies in Contract Planning and Procurement - The Department of Health and Human Services (HHS) inspector...more

Caution: Big Penalties for Reimbursing Health Care Premiums

Even if you are a small employer who is not required to provide your employees with health insurance under the Affordable Care Act (ACA), if you reimburse your employees for health insurance premiums, you run the risk of...more

House Approves Bills to Modify ACA Rules for Employers Related to Part-Time Workers, Veterans

On January 8, 2015, the House of Representatives approved H.R. 30, the “Save American Workers Act.” The legislation would amend the ACA’s definition of “full-time employee” for purposes of the requirement that certain...more

Time to Get Rid of Those Post-it Notes with All Your Passwords!!!

This month, Governor Chris Christie signed into law a New Jersey bill requiring health insurance carriers (e.g., insurance companies, health service corporations, hospital service corporations, medical service corporations,...more

Administration Issues Proposed Rules on ACA Summary of Benefits and Coverage, Excepted Benefits/Wraparound Coverage

On December 30, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise Affordable...more

Manatt on Health Reform: Weekly Highlights: January 2015 #3

This week, leadership changes at CMS continue, Montana’s Governor introduces Medicaid expansion legislation, and the California Marketplace allows new health plan entrants into the individual and SHOP Marketplaces for the...more

BCBSNC Release of Data

After objecting to the release of hospital reimbursement rates mandated under North Carolina’s Health Care Cost Reduction and Transparency Act of 2013 (NCGS Section 131E-214.5), Blue Cross Blue Shield of North Carolina...more

Small Nonprofit? Get the Credit You Deserve!

In March 2010, the Affordable Care Act was enacted to encourage small businesses and tax-exempt organizations to offer health insurance to their employees for the first time or continue the health care coverage they already...more

New Jersey Requires Encryption for Health Insurance Carriers; May Open Door to Class Action Suits over Violations Under State...

Gov. Chris Christie has signed into law S. 562, which, as its title states, “Requires health insurance carriers to encrypt certain information.” Violation of this new law constitutes a facial violation of the New...more

Health Headlines: Also in the News - January 2015 #2

House Passes Bill to Redefine Full-Time Employee Under ACA – On January 8, 2015, the House of Representatives in a 252-172 vote approved a bill that would redefine a full-time worker under the ACA employer mandate from one...more

New York Passes Telemedicine Reimbursement Legislation

New York became the 22nd state to sign into law legislation that will require commercial and Medicaid plans to provide coverage of telehealth and telemedicine services. The law, originally intended to take effect on January...more

News from the Health Law Gurus™:

News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories....more

Manatt on Health Reform: Weekly Highlights: January 2015 #2

This week’s highlights include movement in states’ Marketplace and Medicaid leadership positions; Idaho takes a hard look at Medicaid expansion, and federal officials help Marketplace enrollees prepare for the 2014 tax...more

Benesch Health Care Market Intelligence - Physician/Hospital Summary Report 2014

In this Report: - Key Findings - Industry Trends – Hospitals - Industry Trends – Physician Practices - Government/Regulatory – Ohio - Government/Regulatory – U.S. -...more

Employing Veterans May Help Avoid the ACA’s Employer Mandate

The new Republican Congress began its session with an attempt to narrow the Affordable Care Act’s (ACA) employer mandate by exempting certain veterans and their families from counting toward the number of employees at small...more

Obama Administration Seeks Comments on Proposed Changes to Summary of Benefits and Coverage Document and Requirements

On December 30, 2014, the Departments of Health and Human Services, Labor, and the Treasury (collectively, “Departments”) issued a proposed rule (“Proposed Rule”) regarding the summary of benefits and coverage (“SBC”) for use...more

Health Care Update - January 2015

In This Issue: - SGR Already Strong Focus of 114th Congress: - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional Initiatives - Other Health...more

New York Passes Telehealth Bill

New York Governor Andrew Cuomo signed a Bill late last week, which will take effect as of January 1, expanding telehealth coverage in New York. This law does three things which are on the leading edge of telehealth coverage....more

Texas Adopts Standard Prior Authorization Form

In an effort to reduce the number of different prior authorization forms with which providers must contend, the Texas Department of Insurance (TDI) has adopted a single, standard form for requesting prior authorization of...more

California Insurance Commissioner Issues Emergency Regulations Affecting Narrow Provider Networks

On January 5, 2015, Commissioner Dave Jones issued emergency regulations affecting health insurers with respect to access to provider networks in response to consumer complaints that appointments with physicians are hard to...more

Challenges Physicians Can Expect in 2015

Reimbursement for medical services continues to decline. Continuing uncertainty about the Affordable Care Act persists. Government regulations create burdensome paperwork, busywork, and compliance headaches. Technology costs...more

Warning: Don’t Lose your Right to Contest Medical Treatment

Newly implemented rule (04 NCAC 10A.1001 [Rule 1001]) requires, among other things, that you immediately respond to requests for authorization for surgery and hospitalization. Under this rule, you have only seven days to...more

Year-End Legislation Important for Employers

The 2015 Cromnibus and the Tax Increase Prevention Act of 2014 solve some problems and raise others. On December 16, 2014, U.S. President Barack Obama signed the Consolidated and Further Continuing Appropriations Act...more

A Quick Look at Healthcare Issues Expected to Make News in 2015

As we look into our crystal balls, we do not expect a lot of new issues in 2015. Rather, we believe that most of the significant issues will be a continuation of issues that arose in 2014 or earlier. ...more

Manatt on Health Reform: Weekly Highlights: January 2015

Enrollment and coverage expansion tops the new this week. Federal officials announced 6.5 million people have enrolled through the Federally-facilitated Marketplace and released the first in a monthly series of detailed...more

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