Podcast: Health Reimbursement Arrangements
K&L Gates Triage: An Insider’s Perspective on the Health Care Debate in Washington, DC
How Does King v. Burwell Decision Affect the Affordable Care Act?
The Affordable Care Act: The Structure of Health Plans – Interview with Alden Bianchi, Member, Mintz Levin
Does the Affordable Care Act really make health insurance more affordable?
The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more
Reimbursement for health care services in California continues its shift toward capitation, resulting in health care providers increasingly forming their own health plans under the Knox Keene Health Care Service Plan Act (the...more
On May 16, 2014, the Centers for Medicare & Medicaid Services ("CMS") released a final rule titled "Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond" ("Final Rule")...more
Congress held several hearings last week ranging from Sylvia Burwell’s nomination for Secretary of the Department of Health and Human Services (HHS), to Medicare payment oversight, to post-acute care in Medicare. The Centers...more
On February 4, 2014, CMS released a Draft Letter containing guidance for issuers seeking to offer Qualified Health Plans (QHPs) in Federally-Facilitated Marketplaces (FFMs). The Draft Letter offers operational and technical...more
In This Issue: - Top News ..HHS Gives Mixed Messages Regarding Federal Health Care Program-Status of Qualified Health Care Plans (QHPs) ..HHS Issues Health Insurance Marketplace Enrollment Report Snapshot ...more
As the healthcare community readies itself for patients securing health coverage through the exchanges, various techniques are being considered to encourage and facilitate patient enrollment in a health plan. One question...more
Recent seemingly contrary determinations by the U.S. Department of Health and Human Services (HHS) have fueled industry speculation regarding whether qualified health plans (QHPs) available on the health insurance exchanges...more
Following last week's declaration that Qualified Health Plans (QHPs) on HealthCare.gov are not "Federal health care programs," and thus are not subject to the federal Anti-Kickback Statute, CMS released additional guidance...more
The Department of Health and Human Services (HHS) recently announced that qualified health plans (QHPs) established by the Affordable Care Act (ACA)—which include federally-facilitated insurance exchanges and federal...more
In an October 30th letter addressed to Congressman Jim McDermott, the Department of Health and Human Services (HHS) Secretary, Kathleen Sebelius, left little to interpretation: Qualified health plans (QHPs) purchased through...more
In a letter to Rep. Jim McDermott dated Oct. 30, 2013, Department of Health and Human Services Secretary Kathleen Sebelius clarified that qualified health plans (“QHPs”) available on the health insurance exchanges under the...more
In a surprising move late last week, HHS Secretary Kathleen Sebelius announced that qualified health plans (QHPs) purchased through the Affordable Care Act’s (ACA) insurance exchanges are not “federal health care programs”...more
State health insurance exchanges are virtual marketplaces that were created by the Patient Protection and Affordable Care Act ("PPACA") to allow private insurance companies to sell qualified health plans ("QHP") meeting...more
On September 27, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Arkansas’s waiver to implement the Affordable Care Act (ACA) Medicaid expansion by using premium assistance to purchase QHPs in the Health...more
Health insurance exchanges (commonly called the MarketPlace or the Exchanges) are a complex and highly debated part of the Affordable Care Act (ACA). With the looming January 1, 2014, deadline to open the marketplace for...more
Engaging Consumers to Improve Integrated Care Models - Integrated care is a growing trend in health reform, as states seek to improve care quality, health outcomes and patient satisfaction while containing healthcare...more
On June 14, 2013, HHS released a proposed rule containing many provisions aimed at oversight of federally-facilitated exchanges (FFEs), state health insurance exchanges (State Exchanges), qualified health plan (QHP) issuers,...more
The Affordable Care Act (ACA) requires a coordinated and streamlined eligibility and enrollment process for all Insurance Affordability Programs (IAPs), including Medicaid, the Children’s Health Insurance Plan (CHIP), and...more
Clearing up the Rumors around Health Reform Delays: What Really Happened, What Won’t and Steps Employers and Insurers Can Take Now - Rumors are flying in health policy circles that the Obama Administration might delay...more
On Friday, April 5, 2013, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (45 CFR Part 155) that clarifies and implements standards for providers of consumer-related assistance under the...more
On March 11, 2013, the Department of Health and Human Services (HHS) published a proposed rule that would amend an earlier final rule related to health insurance exchanges and, more specifically, the Small Business Health...more
The New York Department of Health's Office of the New York Health Benefit Exchange issued the long-awaited "Invitation to Participate in the New York Health Benefit Exchange" (the "Invitation") on January 31, 2013. The...more