Health Insurance

News & Analysis as of

Competition & Regulation Update: Good News For The Private Health Insurance Sector… But How Long Will The Wait Be?

In our update on 10 April 2015, we highlighted the key recommendations of relevance to the private health insurance industry contained in the final report of the Competition Policy Review Panel chaired by Professor Ian Harper...more

Internet Posting of SPD is Insufficient

Employers know that they must prepare and distribute a summary plan description (SPD) for their ERISA benefit plans, including retirement benefits, health insurance, life insurance and disability insurance. Because of the...more

Blog: CareFirst Discloses Data Breach

CareFirst, a Blue Cross Blue Shield plan serving the Washington D.C. metro area, became another in a line of health insurers to suffer a data breach as a result of hackers. CareFirst and the FBI are examining the breach...more

CareFirst announces breach of 1.1 million records in cyberattack

Following in the footsteps of Anthem and Premera, CareFirst, a Blue Cross Blue Shield plan servicing customers in Maryland, Washington, D.C. and Virginia announced yesterday that it too has been the victim of a...more

Legislation Proposed In New Jersey to Alert Patients to Out-of-Network Costs

On May 14, 2015, four New Jersey legislators introduced the Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the "Legislation"). If enacted, the Legislation would increase health care...more

Businesses May Have Until At Least 2017 To Recover Hidden Access Fees Taken By Blue Cross Blue Shield

Great news for the hundreds of businesses from which Blue Cross Blue Shield of Michigan charged hidden fees: a federal court's recent ruling indicates that the businesses have several more years to file claims against BCBSM...more

OIG Early Alert on State-Based ACA Marketplace Funding Use

The OIG has issued an “Early Alert” warning regarding the use of federal funding by state-based marketplaces under the Affordable Care Act (ACA). The OIG notes that the ACA clearly prohibits marketplaces from using grant...more

Health Update - May 2015

Building a Culture of Health: The Value Proposition of Retail Clinics - Editor’s Note: Since first emerging on the healthcare landscape more than 15 years ago, retail clinics have seen significant growth. There are now...more

CareFirst Suffers Cyberattack, Data Breach of 1.1 Million Customers’ Information

BREAKING NEWS: Health insurer CareFirst BlueCross BlueShield disclosed today that hackers gained access to one of its databases, exposing personally identifiable information for approximately 1.1 million people....more

EEOC Proposes Regulatory Clarification on the Application of the ADA to Employer Wellness Program Incentives

Action Item: Employers who already have, or are considering implementing, wellness programs that involve cost-sharing reductions or other financial incentives for participants should carefully review their programs given the...more

Changes to Insurance Requirements for J-1 Visa Exchange Programs

In October of 2014, the U.S. Department of State revised Subpart A of the exchange visitor regulations. Changes to the reporting and English language proficiency requirements for exchange programs went into effect on January...more

Tax Law Blog: Health Savings Accounts: Beneficiaries and Taxes

As high deductible health insurance plans become more prevalent, so do health savings accounts (HSAs). While most participants are aware of the tax implications of an HSA during life (contributions are deductible from gross...more

Insurer Wrongfully Passed Sequestration Cuts Through to Providers

A Pennsylvania judge found, on May 6, 2015, that a Medicare Advantage Plan had no right under its participation agreements to pass CMS sequestration reductions through to participating providers. Judge R. Stanton Wettick Jr....more

Manatt on Health Reform: Weekly Highlights - May 2015 #3

Washington and Iowa report surges in insurer participation in Marketplaces for 2016; Maine considers legislation to maintain premium subsidies regardless of King v. Burwell. KING V. BURWELL ACTIVITY: Maine:...more

The ACA’s Toyota tax

For several years now, employers have spent a great deal of time focusing on the Affordable Care Act’s (ACA) play-or-pay mandate. Numerous articles have been written and numerous educational seminars have been given...more

Issues Concerning Medical Identity Theft

Whenever a large data breach occurs in the healthcare industry, such as the Anthem Blue Cross Blue Shield breach this past winter, some news stories always seem to focus on the strange medical catastrophes that could...more

Religious Freedom and the Affordable Care Act

The fascinating interplay that weaves between the First and Fifth Amendments to the U.S. Constitution, the Religious Freedom Restoration Act (RFRA) and the Patient Protection and Affordable Care Act (ACA) continues to march...more

Washington Healthcare Update

This Week: Health Subcommittee Advances 21st Century Cures, Full Committee Action Scheduled…Senate Finance Committee Hearing: Chair Hatch to Launch New Initiative on Improving Chronic Care for Medicare Patients…Hawaii’s...more

IRS Provides Penalty Relief for Incorrect or Delayed Forms 1095-A

The IRS issued Notice 2015-30, which provides penalty relief for taxpayers who received an incorrect or delayed Form 1095-A. Form 1095-A is provided to all individuals who enrolled in health insurance coverage through the...more

New FAQs Regarding Preventive Services Under Healthcare Reform McGuireWoods Healthcare Reform Guide: Installment No. 49

This is the 49th in a series of WorkCite articles concerning the Patient Protection and Affordable Care Act and its companion statute, the Health Care and Education Reconciliation Act of 2010 (referred to collectively as the...more

EEOC Issues Proposed Rule Addressing Employer Wellness Programs and the ADA

On April 20, 2015, the Equal Employment Opportunity Commission (“EEOC”) issued a proposed rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (“ADA”) as it...more

IREG Update

Commercial Accountable Care Organizations - Models of health care delivery are evolving on many fronts, driven by the overriding goals of lowering the cost of health care and increasing its quality. Traditional private...more

Manatt on Health Reform: Weekly Highlights - May 2015 #2

Latest numbers show dramatic post-ACA coverage gains; in California, an increase in dental-related ER visits follows cuts to Medicaid dental benefits; and the Massachusetts governor requests to maintain its definition of...more

House Bill Says 23 Years Isn’t Long Enough for Transition to ICD-10

All across the country hospitals have been bracing for the scheduled Oct. 1, 2015, transition from ICD-9 coding to ICD-10. It had been scheduled for Oct. 1, 2014, but the Protecting Access to Medicare Act of 2014 delayed it...more

What’s Up With Wellness Programs Anyway?

My personal interest in employer wellness programs increased a few months ago when my wife and I were offered significant health insurance premium savings through her employer by participating in such a program. We completed...more

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