News & Analysis as of

Health Insurance Exchanges Medicare

Health Insurance Exchanges are government-regulated private health insurance markets where individuals can purchase standardized health insurance plans.
Sheppard Mullin Richter & Hampton LLP

Health and Human Services Exchange Program Integrity Final Rule

On December 20, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on program integrity for Affordable Care Act (ACA) exchange plans. This rule implements a number of provisions from the ACA,...more

King & Spalding

Health Plan Responsibility to Pay for Hospital Inpatient Care When Members Await Placement at Post-Acute Facilities

King & Spalding on

Hospitals that attempt to discharge a patient to a post-acute level of care but are not able to because they cannot find an appropriate accepting facility must continue providing care if the patient cannot be safely...more

Obermayer Rebmann Maxwell & Hippel LLP

TRANSPARENCY: Embracing CMS’s Push To Publicize Your Organization’s Performance

The Centers for Medicare and Medicaid Services (CMS) is launching new value-based programs with great fervor as a central strategy to bend the healthcare cost curve. Value-based reimbursement models linked to achieving the...more

Orrick, Herrington & Sutcliffe LLP

Will the GOP's AHCA Repeal and Replace the ACA?

We promised to keep you up to date on the GOP majority's promise to repeal and replace the Affordable Care Act (the "ACA"). After reaching agreement on several amendments to the original House bill (described in our previous...more

FordHarrison

ACA Repeal Effort Moves to Senate - Employers Should Continue Compliance for Now

FordHarrison on

The U.S. House of Representatives has passed legislation that would effectively eliminate the Affordable Care Act’s (ACA’s) employer mandate, open the door for simplified employer coverage reporting, provide greater...more

Littler

House Passes American Health Care Act: Fate in the Senate Uncertain

Littler on

Seven years after the Affordable Care Act (ACA) was enacted, the U.S. House of Representatives voted on May 4, 2017, to dismantle the sweeping law and replace key provisions with a dramatically different vision of health care...more

Seyfarth Shaw LLP

Issue 109: House Passes Modified Version of AHCA - Bill to Proceed to Senate

Seyfarth Shaw LLP on

This is the one hundred and ninth 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

Franczek P.C.

U.S. House of Representatives Approves ACA Repeal Bill

Franczek P.C. on

On May 4, 2017, the U.S. House of Representatives narrowly approved a revised version of the American Health Care Act (“AHCA”), a bill that both repeals certain parts of the Affordable Care Act (“ACA”) and provides new...more

Ballard Spahr LLP

House Passes American Health Care Act

Ballard Spahr LLP on

As widely reported, the U.S. House of Representatives has passed the American Health Care Act (AHCA), a bill that, if enacted, would make the first major legislative changes to the Affordable Care Act (ACA). Modified to...more

Carlton Fields

The Affordable Care Act: On the Fast Track to Repeal

Carlton Fields on

On January 20, hours after his inauguration, President Donald Trump issued an executive order directing the heads of all executive departments and agencies to “waive, defer, grant exemptions from, or delay the implementation...more

Sheppard Mullin Richter & Hampton LLP

Part 3: Exploring “Repeal and Replace”

In Part II of our blog series, Very Opaque to Slightly Transparent: Shedding Light on the Future of Healthcare, we considered potential healthcare market consequences of a partial repeal of the Affordable Care Act (ACA). In...more

Proskauer Rose LLP

The ERISA Litigation Newsletter - December 2016

Proskauer Rose LLP on

This month Richard Zall, Chair of Proskauer's Health Care Department, explores developments likely to occur with respect to the Affordable Care Act as a result of the new administration. In our Rulings, Filings and...more

Sheppard Mullin Richter & Hampton LLP

“May You Live in Interesting Times” – Some Healthcare Predictions for the Trump Administration’s First Year

The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - April 2016 #4

CMS's sweeping final rule aligns Medicaid and CHIP managed care with QHP and Medicare Advantage regulations; New York's DSRIP is enabling change in the State's Medicaid delivery system; and Medicaid expansion reduces...more

Burr & Forman

2015 Health Care Year in Review

Burr & Forman on

In 2015, ICD-10 finally became a reality, and the dire predictions of problems seem to be wrong. Providers now have codes to describe just about every conceivable (and a few simply bizarre) medical occurrences. If a patient...more

Alston & Bird

Health Care Advisory: Highlights of the OIG’s 2016 Work Plan

Alston & Bird on

On November 2, 2015, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its Work Plan for Fiscal Year 2016 (“2016 Work Plan”).1 The 2016 Work Plan outlines the areas of...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

Elections for Speaker of the House and Potential Changes at Ways and Means Committee - Rep. Paul Ryan (R-WI) announced Tuesday (Oct. 20) that he will run for the House Speaker position if the major House Republican...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

Mintz - ML Strategies

Health Care Update - October 2015

Mintz - ML Strategies on

Cuts in Mandatory Entitlement Programs Center of Budget Negotiations: As budget negotiators from both sides of the Hill come together to work out a two-year budget deal, determining how sequestration relief will be paid for...more

Manatt, Phelps & Phillips, LLP

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

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

Faegre Drinker Biddle & Reath LLP

A First Step on a Long Road: CMS Begins Implementation of ACA Transparency Standards

On August 11, 2015, the Centers for Medicare and Medicaid Services (CMS) posted for public comment notice of a new required data collection for health insurers. Its purpose is to begin the implementation of section 1311 of...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - August 2015

Increased plan choice on HealthCare.gov is linked to lower premium growth; Arizona seeks changes to Medicaid expansion; and California and New York release detailed Marketplace and Medicaid enrollment reports....more

Mintz - ML Strategies

Health Care Update - July 2015 #3

Mintz - ML Strategies on

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

Mintz - ML Strategies

Health Care Update - July 2015

Mintz - ML Strategies on

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

McDermott Will & Emery

Challenges Facing “Narrow” Provider Networks on the ACA Health Care Insurance Exchanges

McDermott Will & Emery on

In This Issue: - The Driving Forces Behind the Trend Toward Narrower Networks - The Trade-Off - Regulatory, Legislative and Litigatious Responses to Narrower Networks Across the Nation - Judicial and CMS...more

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