Health Insurance

News & Analysis as of

Has the Supreme Court Given Advance Notice How It Will Decide King v. Burwell?

On Wednesday, March 4, 2015, the Supreme Court will hear argument in King v. Burwell, the most publicized case in some time. Most readers are aware that the issue is whether certain tax subsidies essential to the proper...more

Health Care Reform in America: The Good, The Bad And The Ugly

Health care providers, the insurance industry, and all of us as health care consumer continue to experience the difficult birth pangs of the Patient Protection and Affordable Care Act ("ACA" or the "Act"). Political battles...more

Could a Cadillac Health Plan Put the Brakes on Obamacare?

The Supreme Court is hearing oral arguments Wednesday, March 4 on certain aspects of the Affordable Care Act. This has the potential to unravel President Barack Obama’s beloved health care plan. Another aspect of...more

Attention Seniors! Check Into a Hospital and Get $100!

OIG Advisory Opinion 15-03 approves a Medigap insurer’s program that, among other things, calls for (a) network hospitals to waive the deductible for Medicare enrollees, (b) the insurer to pay the hospital network a fee each...more

CMS Finalizes 2016 ACA Marketplace Plan Benefit & Payment Parameters

The Centers for Medicare & Medicaid Services (CMS) has finalized its Affordable Care Act (ACA) Marketplace health plan payment parameters and essential benefit standards for 2016. ...more

CMS Issues Final 2016 Funding Methodology for ACA Basic Health Program

On February 24, 2015, CMS published its final methodology and data sources for determining federal payment amounts for states that elect to use the Basic Health Program to offer health benefits to low-income individuals...more

OIG Announces Plans for Health Reform Oversight Activities

On February 24, 2015, the HHS Office of Inspector General (OIG) released its “Health Reform Oversight Plan” for FY 2015, which describes the OIG’s current and planned efforts to oversee the implementation and management of...more

DOJ and FTC Announce Proactive Approach to Monitoring Post-Affordable Care Act Antitrust Compliance at Joint Workshop

On February 24 and 25, the DOJ and FTC held their second joint workshop to examine the state of health care competition in the United States. The workshop explored five main themes: early observations regarding accountable...more

FTC and DOJ Host Workshop Examining Health Care Competition - Updated 2015

The Federal Trade Commission (FTC) and the Antitrust Division of the U.S. Department of Justice (DOJ) held a public workshop on February 24–25, 2015, to examine recent trends and developments in health care provider...more

King v. Burwell: What to Expect From the Supreme Court Argument

On Wednesday, March 4, 2015, the Supreme Court of the United States will hear argument in King v. Burwell, a case involving premium tax credits under the Affordable Care Act (ACA). Among its many provisions, the ACA includes...more

Legal Alert: IRS Offers Rules of the Road for Cadillac Plan Tax

On February 23, the Internal Revenue Service (IRS) issued Notice 2015-16 (Notice), which describes several possible approaches for implementing the excise tax on high-cost employer-sponsored health care plans (also known as...more

State Attorneys General Return to Health Care Reform in U.S. Supreme Court

On Wednesday, the U.S. Supreme Court will hear arguments in what is being teed up to be “Round 2” on the Affordable Care Act (ACA). In the case King v. Burwell, the question before the Court is whether the IRS can extend tax...more

On the Eve of Oral Arguments before the U.S. Supreme Court in King v. Burwell: Obamacare in the Balance

As every healthcare geek and Supreme Court wonk will tell you, on March 4, the U.S. Supreme Court will hear oral argument in King v. Burwell (an amalgamation of four cases – King v. Burwell, Halbig v. Burwell, Pruitt v....more

Week in Review - February 2015 #4

MNsure Reform - Minnesota’s already low rate of people without health insurance fell even more over the past year, a survey from Gallup finds. At the beginning of 2014, just 9.5 percent of Minnesotans lacked health...more

Competition and Regulation Update: Health Sector Under ACCC Spotlight In 2015

ACCC ENFORCEMENT PRIORITIES - The Australian Competition and Consumer Commission (ACCC) has released its enforcement priorities for 2015, with the Chairman of the ACCC giving a speech on the topic last week. Each year,...more

Permissible Discrimination in Health Benefits

The intense regulation of health care benefits, especially with respect to the Affordable Care Act, has created much confusion among employers. As a result, many employers do not understand that they may offer different...more

Tennessee Supreme Court Holds That Healthcare Providers Can Only collect What Insurance Companies are willing to Pay

A woman is seriously injured in a car accident. It is not her fault. She is taken to the emergency room where she is treated. When she is released, the hospital bills total $100,000. The woman has health insurance. The...more

Worker Classification Impacts ACA Excise Tax

A reminder to employers who are now calculating whether or not they are an “applicable large employer” for purposes of the shared responsibility payment effective this year under the Affordable Care Act. The Act considers all...more

Five Health Care Developments Important to Employers

Perhaps never before have employers faced so many challenges when it comes to health care issues affecting their workforce. Congress may try to amend the Affordable Care Act (“ACA”). The Supreme Court of the United States is...more

Premium Reimbursement Arrangements Get Relief - More ACA Transition Relief—This Time for Small Employers and S-Corps

The IRS issued guidance on Feb. 18, 2015, providing temporary relief until June 30, 2015, from steep penalties for small employers and S-corps that have continued to use premium reimbursement arrangements to provide health...more

Limited Transition Relief Provided for Employer Payment Plans

The Internal Revenue Service (IRS) recently issued additional guidance (Notice 2015-17) addressing the treatment of arrangements whereby an employer reimburses an employee for some or all of the premium expenses incurred for...more

New Jersey Imposes Unique Encryption Requirements

Effective August 1, 2015, New Jersey will require health insurance carriers authorized to issue health benefit plans in New Jersey to encrypt personal information that they store electronically....more

Partial Relief for Employer Payment of Individual Insurance Premiums

In a recent notice, the Internal Revenue Service has tempered prior guidance that closed the door on employer arrangements for paying the cost of individual health insurance for employees. The IRS still views these premium...more

States Respond to Recent Breaches with Encryption Legislation

In the wake of recent breaches of personally identifiable information (PII) suffered by health insurance companies located in their states, the New Jersey Legislature passed, and the Connecticut General Assembly will consider...more

Manatt on Health Reform: Weekly Highlights - February 2015 #4

Wrapping up the 2015 enrollment period, Healthcare.gov and State-based Marketplaces in seven states have announced special enrollment periods (SEPs) for people who were uninsured in 2014 and discover they owe a “shared...more

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