Health Insurance Exchanges Dept. of Health and Human Services

Health Insurance Exchanges are government-regulated private health insurance markets where individuals can purchase standardized health insurance plans.
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News from the Health Law Gurus™

Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week that the information of approximately 4.5 million individuals has been affected by...more

Monthly Benefits Update - July 2014

Two federal appeals courts issued contradictory rulings on the validity of subsidies for the purchase of health insurance under the federal marketplace established pursuant to the Affordable Care Act (ACA). On July 22, a...more

Do Subsidized Health Care Plans Purchased Under the Affordable Care Act Trigger the Anti-Kickback Statute?

The advent of federally subsidized private pay health insurance under the Affordable Care Act has the potential to expand the application of the federal anti-kickback statute beyond just Medicare, Medicaid, and Tricare. The...more

Health Care Reform Implementation Update - June 2014

Secretary Burwell continues to settle in to her new position as the Department of Health and Human Services (HHS), this week making a number of management changes at the department; CMS released the long awaited proposed rule...more

Health Care Reform Implementation Update

Affordable Care Act (ACA) action on Capitol Hill this past week centered on investigations into improper ACA subsidy payments, a potential constitutional amendment proposal, and support for an appeal of the ACA in favor of a...more

Is It a Violation to Help?

In a May 21, 2014, letter to the President of the American Hospital Association (AHA), U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius confirmed HHS’s position that private, not-for-profit...more

Health Care Reform Implementation Update - May 2014

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

HEAL Advisory: New COBRA Model Notices and Coordination with Marketplace Enrollment

On May 2, 2014, the U.S. Departments of Labor and Health and Human Services published a series of guidance and model notices clarifying the provision of health insurance to recently terminated employees. The Department of...more

HHS Creates A New And Limited Special Enrollment Opportunity In States With Federally-Facilitated Health Insurance Exchanges

On May 2, 2014, the Department of Health and Human Services (HHS) released guidance which creates a special enrollment opportunity in states with a federally-facilitated health insurance Marketplace (Marketplace) for...more

News from the Health Law Gurus™ - May 2014

Massachusetts to Start from Scratch with Health Insurance Website — Massachusetts plans to abandon its health insurance exchange website in favor of starting over from scratch, according to a New York Times report....more

New Model COBRA Notices

To coordinate information about the new marketplace/exchange coverage that may be available under the Affordable Care Act, today the U.S. Department of Labor, in conjunction with the IRS and U.S. Department of Health and...more

HHS Report Highlights “Surge” In Enrollment in Health Insurance Marketplaces

Last week, HHS’s Office of the Assistant Secretary for Planning and Evaluation published a Report offering health plan enrollment data for the state-based insurance marketplaces authorized by the Affordable Care Act...more

Health Care Update

In This Issue: - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health Care News - Upcoming Hearings and...more

Health Reform + Related Health Policy News - April 2014

In This Issue: - Top News ..Sebelius: No More Health Law Delays; No Enrollment Extension ..CMS Announces Innovative Hospice Care Model - State News ..17 States and D.C. Implementing SHOP Health Insurance...more

March 31: ACA Deadline or Just Another Monday?

March 31, 2014 is the open enrollment deadline for individuals who want to buy health insurance through the Health Insurance Marketplace (also known as the “Exchange”). Or is it?...more

Health Care Reform Implementation Update - January 24, 2014

In a high-stake but relatively uneventful series of negotiations, the House and Senate passed a continuing resolution to fund the government through September, averting another government shutdown. Also over the past week,...more

The Affordable Care Act Comes Of Age

Since President Obama signed the Patient Protection and Affordable Care Act (ACA) in March 2010, various provisions of the law have taken effect. However, its core pieces become effective this year....more

Health Care Reform Implementation Update - December 19, 2013

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

Health Care Reform Update -- November 25, 2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; and Hearings and Mark-Ups Scheduled. Excerpt from...more

Health Reform + Related Health Policy News - November 2013 - Issue 1

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...more

Healthcare Complexity: Do Exchange Plans Qualify as Federal Healthcare Programs

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

HHS's Mixed Messages: Identifying a Federal Healthcare Program When You See It

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

May Providers Pay Health Insurance Premiums for HealthCare.gov Plan Enrollees?

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

HHS Guidance Clouds Earlier Statement, Discourages Providers From Purchasing Insurance For Patients

There has been much speculation in the health care community that it may be financially beneficial, under certain circumstances, for hospitals and other large providers to purchase health care coverage for their indigent...more

HHS Says Qualified Health Plans Are Not ‘Federal Health Care Programs’

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

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