News & Analysis as of

Health Insurance

Health Care Weekly Preview from ML Strategies – April 2017

Welcome back everybody. While the momentum around an American Health Care Act (AHCA) comeback is unclear, there’s no discounting that efforts are ongoing to reach a consensus among House Republicans with significant pressure...more

A Spring Cheat Sheet to Congressional Health Care Policy

Welcome back, friends. While the next stretch likely won’t have the drama of the American Health Care Act (AHCA), there will be plenty happening. There are deadlines that require decisive action on behalf of stakeholders and...more

How Will the Trump Administration Impact Healthcare Litigation?

Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more

Market Stabilization Rule: Assessing the Trump Administration's First ACA Market-Related Regulation

by Faegre Baker Daniels on

On April 13, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized its Marketplace Stabilization Rule. This is the first Trump administration regulation that applies to the health insurance markets remade by...more

Wisconsin Releases Draft Waiver Amendment Proposing New Eligibility Requirements

On April 19, 2017, Wisconsin released for public comment a proposed amendment to its BadgerCare Reform Section 1115 demonstration. BadgerCare Reform currently provides coverage to approximately 150,000 childless adults ages...more

Congress returns with Trump pressing anew for ACA repeal/replace, but with what?

Welcome back, Republicans in Congress. When you went home for spring break, constituents made raucous complaints, if you held town halls, about the GOP’s failure to repeal and replace the Affordable Care Act, aka Obamacare....more

Proving Utility, Demonstrating Value: How to Align the Moving Parts in Personalized Medicine Reimbursement

by Foley & Lardner LLP on

Of the many business, operational, legal, regulatory and clinical obstacles standing in the way of widespread delivery of personalized medicine, the single greatest challenge may lie in solving the reimbursement puzzle....more

Fate Uncertain for HHS’s Extension of ACA Discrimination Protections to Abortion & Gender Transition

by Genova Burns LLC on

In May 2016 HHS issued a final rule implementing the Affordable Care Act’s Section 1557 nondiscrimination provision, which applies to recipients of funding from HHS. The rule prohibits discrimination on the basis of gender...more

Final Market Stabilization Rules – How Stable is Stable?

The Department of Health and Human Services released the final Affordable Care Act marketplace stabilization rules (“Final Rule”) on April 13, 2017. The Final Rules become effective on June 19, 2017 and will, accordingly,...more

Efforts to Revive American Health Care Act (AHCA) Stall Before Recess

by King & Spalding on

Last week, prior to departing Washington, D.C. for a two week congressional recess, House Republicans and the Trump Administration worked to come to an agreement on the American Health Care Act (AHCA), legislation to repeal...more

Market Stabilization: To Be or Not to Be?

by BakerHostetler on

The Centers for Medicare and Medicaid Services (CMS) published a Final Rule intended to stabilize the individual and small group insurance markets on April 18, 2017. Reflecting the urgent need to address the uncertainty...more

Update #7: ACA Market Stabilization Rules Finalized; Cost-Sharing Next Hurdle

by Davis Wright Tremaine LLP on

The Trump Administration has issued final market stabilization rules designed to keep insurers in the individual health insurance Marketplaces. The rules are virtually the same as the proposed rules described in our Update...more

D.C. District Court Allows Part C Plan to Continue with Challenge of Overpayment Rule

by King & Spalding on

On March 31, 2017, Judge Rosemary Collyer of the United States District Court for the District of Columbia held that plaintiffs UnitedHealthcare Insurance Company et al. (“United”) had standing to challenge CMS’s overpayment...more

Health Care Perspectives

With deep experience in the health care industry and a comprehensive understanding of its diverse participants, Katten attorneys serve as conference moderators and panelists, host accredited events, and produce webinars to...more

Stop-Loss Policies, How Low Can You Go?

by Bryan Cave on

On April 5, the “Self-Insurance Protection Act” passed the House and moved to the Senate. This bill, if enacted, would amend ERISA, the Public Health Service Act and the Internal Revenue Code (the “Big 3” statutes containing...more

ML Strategies Alert - FY2018 Massachusetts Budget Update: House Ways and Means Budget

On Monday, April 10th, the House Ways and Means Committee proposed a $40.3 billion budget for FY2018 that calls for increasing spending by 3.8 percent, or about $1.47 billion, above FY2017 levels. The spending increase is...more

Affordable Care Act’s Link to the Administration’s Plans for Tax Reform

by McNair Law Firm, P.A. on

On March 24, 2017 the vote to repeal the Affordable Care Act (‘Obamacare’) was cancelled when it became clear there were not enough Republican votes to move it past the House of Representatives....more

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

Changes to Stabilize HealthCare.gov Have Implications for Employer Sponsored Health Plans

by Winstead PC on

We learn early on that for any action there is a reaction. On Friday, the Department of Health and Human Services released “Market Stabilization” final regulations that will impact group health plans as they plan for 2018....more

Issue 108: HHS Moves Ahead In Face of ACA Uncertainty

by Seyfarth Shaw LLP on

This is the one hundred and eighth issue in our series of alerts for employers on selected topics on health care reform. This series of Health Care Reform Management Alerts is designed to provide an in-depth analysis of...more

Washington, D.C. Update – April 2017

by Baker Donelson on

All of Washington was watching as House Republicans failed to meet a self-imposed deadline to repeal the Affordable Care Act (ACA). The House Republican replacement proposal, the American Health Care Act (AHCA), which had...more

CMS Issues Final Rule to Stabilize ACA Insurance Markets, While Emphasizing Marketplace Woes

by Reed Smith on

The Centers for Medicare & Medicaid Services has published a final rule intended to help improve the risk pool and stabilize the Affordable Care Act (ACA) Insurance Exchanges for 2018 – even as CMS contends that consumers...more

NJ Out-Of-Network Update

Increased Focus on the NJ Surprise Bills Legislation - As you know, New Jersey legislators have been considering laws regulating surprise bills by out of network providers for over 8 years. Recently, activity has...more

House Amends the American Health Care Act: Where Will It Lead?

by Perkins Coie on

On the last day before the U.S. Congress began its spring recess, the U.S. House of Representatives amended the now consolidated bill H.R. 1628, known as the American Health Care Act (the AHCA). We previously discussed the...more

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