Health Insurance

News & Analysis as of

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

HHS proposes significant new network adequacy standards and surprise billing protections for 2017 QHPs; Louisiana's Governor-elect reiterates his intent to expand Medicaid on "Day One"; and California considers pursuing a...more

Washington Healthcare Update

This Week: Congress tries to put together a tax extender package, which may provide an opportunity for some Affordable Care Act changes... HHS releases final rule on bundled payment for Joint Replacement Comprehensive Care...more

Health Alert (Australia) - November 23, 2015

In This Issue: -Judgments; Legislation; and Reports -Excerpt from Judgments: Commonwealth. Federal Court - 17 November 2015 - Burnett v Eastern Health [2015] FCA 1247 The Federal Court of Australia...more

Single-Payer Health Care Plan Makes Ballot, Beer and Wine Initiatives Filed

On Nov. 9, 2015, the Colorado Secretary of State announced that the proponents of a ballot measure to create a single-payer state health care system had submitted a sufficient number of signatures for the measure to appear on...more

Federal Court Determines that Employer Use of Employee Health Insurance Premium Payments Breach of ERISA Fiduciary Duties

On November 9, 2015, Minnesota Federal District Judge Susan Richard Nelson ruled that the president and CEO of Faribault Woolen Mills Company breached his fiduciary duties under ERISA by diverting Employee health insurance...more

ERISA: Medical Providers Lack Standing For Reimbursement — Anti-Assignment Provisions Enforceable

You know that patients typically assign rights under a health insurance plan to the provider of medical services. This is accomplished by signing an assignment form upon intake/admission. Then, the healthcare provider sends...more

Health Alert (Australia) - November 16, 2015

In This Issue: -Judgments; Legislation; and Reports. - Excerpt from Judgments: Commonwealth. Federal Court 11 November 2015 - Ramsay Health Care Australia Pty Ltd v Compton [2015] FCA 1207 The Federal...more

IREG Update - November 2015

Section 1332 waivers—New flexibility coming to a state near you in 2017 - The Affordable Care Act (ACA) includes many new provisions and policies that bring federal regulation into the business of health...more

HHS Appeals Adverse Decision on Fixed Indemnity Attestations

As expected, on Monday, November 9, 2015, the U.S. Department of Health & Human Services (HHS) filed a Notice of Appeal from the decision issued by Judge Royce Lamberth of the United States District Court for the District of...more

It’s health insurance open enrollment — research, choose carefully

November has become more than the month devoted to families and feasting: It’s now the start of the season when Americans try like heck to avoid becoming health insurance turkeys. Open enrollment periods are under way — for...more

ACA Reporting 101

One of the new Affordable Care Act (ACA) requirements imposed on employers is the obligation to report employee group health plan coverage information to the IRS and employees on Forms 1094-C and 1095-C. The first required...more

Medicare Open Enrollment Means It's Time to Shop Around

Are you happy with your Medicare coverage? Could you get a better plan for less money? It is time to review whether your plan or plans are working for you. Medicare's open enrollment period, in which you can enroll in or...more

Budget Legislation Repeals Affordable Care Act’s Automatic Enrollment Requirement for Large Employers

The Bipartisan Budget Act of 2015, Pub. L. No. 114-74, which was signed by President Obama on November 2, 2015, included a little-publicized provision that repealed the Affordable Care Act’s automatic enrollment requirement. ...more

Manatt on Health Reform: Weekly Highlights - November 2015

Montana receives approval to expand Medicaid beginning 2016; California’s $6.2 billion Medicaid waiver receives pre-approval; and HHS proposes broadening circumstances under which states receive enhanced federal matching...more

New FAQs on Preventive Services, Wellness Program Rewards and Mental Health and Substance Use Treatment: McGuireWoods Healthcare...

This is the 54th 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

November and December 2015 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties. To avoid such...more

New Affordable Care Act FAQs Provide Guidance on Preventive Services, Wellness Programs and Mental Health Parity

On October 23, 2015, the Departments of Labor, Health and Human Services and Treasury (the “Agencies”) jointly released their twenty-ninth (XXIX) set of Frequently Asked Questions (FAQs) about Affordable Care Act (ACA)...more

Recent Government-Issued FAQs Cause Plan Sponsors to Clarify Preventive Care and Wellness in Health Plan Communications

On October 23, 2015, the U.S. Departments of Labor (DOL), Health and Human Services (HHS), and Treasury issued frequently asked questions (FAQs) on the implementation of preventive care and wellness provisions of the...more

Justice Department Charges Pharma President with Kickback Conspiracy

In the public relations battle following the issuance of the Yates Memo, the Justice Department can now cite one example for the new policy – the recent arrest and charging of Carl Reichel, former President of Warner...more

Three Pressing Challenges for Personalized Medicine

Personalized medicine can be described as the science of targeted therapies. Advances in diagnostic and molecular medicine have made it possible to more precisely identify alternative treatment options for patients based on...more

Health Conscious? The EEOC Is Expanding Incentives for Employees’ Spouses

Employee wellness programs are frequently a source of ulcer-causing angst for employers, but the Equal Employment Opportunity Commission (EEOC) is making moves to treat some of the underlying issues. Late last week, the EEOC...more

ACA Automatic Enrollment Mandate Repealed by Bipartisan Budget Act

On Monday, November 2nd, the President signed the Bipartisan Budget Act of 2015 (BBA). Some legislators had hoped that a budget deal would at least include a repeal of the controversial 40% excise tax on high-cost health...more

Benefits Fast Facts

PACE Act: Some Positive News For Employers With 51 To 99 Employees - For insurance market reform purposes, the Affordable Care Act (ACA) initially defined “small employers” as those with fewer than 50 employees. This...more

Congress Takes Long Look at Proposed Health Insurance Mergers

While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

States Take Aim At Health Insurance Providers Fee In New Litigation

Three states—Kansas, Louisiana and Texas—filed a complaint in federal court on October 22, 2015 challenging the constitutionality and legality of the Affordable Care Act’s health insurance providers fee. The health...more

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