News & Analysis as of

Health Insurance Patient Protection and Affordable Care Act (PPACA) Insurance Industry

McGlinchey Stafford

Podcast: Reflections on Insurance Regulation: A Conversation with McGlinchey’s Newest Member, Former Commissioner Donelon, Part 1...

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In this installment of the More with McGlinchey Podcast, Insurance Regulatory Member Lauren Ybarra interviews Member and Former Louisiana Insurance Commissioner Jim Donelon. They reflect on Jim’s tenure as Louisiana’s...more

Hall Benefits Law

HHS Issues Proposed Rule on Nondiscrimination in Health Programs and Activities

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The U.S. Department of Health and Human Services (HHS) has issued a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” The proposed rule, designed to advance health equity and protect people from...more

Hall Benefits Law

Court Orders Claims Reprocessing After Finding TPA Illegally Excluded Gender-Affirming Care in Violation of ACA Section 1557

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A federal district court has awarded injunctive relief, including claims processing, after finding that an insurer acting as a third-party administrator (TPA) for a self-insured plan violated Section 1557 of the Affordable...more

Epstein Becker & Green

Fifth Circuit Poised to Uphold Ruling Striking Down Preventive Coverage Requirement

A federal appeals court panel in New Orleans is poised to uphold a lower court ruling enjoining the enforcement of the Affordable Care Act's (ACA) requirement that most private health insurance cover recommendations of the...more

McDermott Will & Emery

[Webinar] Gender-Affirming Benefits: Best Practices for Group Health Plans - February 29th, 1:00 pm - 1:30 pm EST

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Employers and plan sponsors are facing growing – and often conflicting – pressures related to the coverage of gender-affirming care. Join McDermott lawyers Sarah G. Raaii and Alden J. Bianchi for a webinar to review recent...more

Verrill

ACA Compliance When Employees Move from Full-Time to Part-Time Mid-Year

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We are well into the Affordable Care Act (“ACA”) information reporting season. Forms 1095-B/1095-C must be provided to employees by March 1, 2024, and the deadline for electronic transmittal of Forms 1094-B/1094-C to the IRS...more

McDermott Will & Emery

Special Report - Funding Employer-Sponsored Group Health Coverage: The Group Captive Solution - November 2023

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Employer-sponsored health insurance covers almost 159 million non-elderly US workers and their dependents, and employees and jobseekers alike view group health coverage as the single most important non-cash job-related...more

Venable LLP

NAIC Working Group Approves Revisions to Regulate Health Insurance Lead Generators

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This August, a working group sponsored by the National Association of Insurance Commissioners (the "NAIC") unanimously approved revisions to the NAIC's Unfair Trade Practices Act Model #880 (the "Model Law") to restrain...more

Zuckerman Spaeder LLP

Whither Insurance Coverage for Preventive Health Services? District Court Decision Striking Down Affordable Care Act’s Preventive...

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On May 15, 2023, the Fifth Circuit temporarily stayed a district-court ruling that struck down a key part of the Affordable Care Act (ACA). As a result of the stay, the ACA’s health insurance coverage requirements for...more

Bradley Arant Boult Cummings LLP

ACA Preventive Services Mandate Partially Vacated: What’s Affected, What’s Not, and What’s Next

A federal judge has struck down a provision of the Affordable Care Act (ACA) mandating group health plans and insurers to cover a long list of preventive services without cost-sharing from participants. The March 30 decision...more

Manatt, Phelps & Phillips, LLP

Realizing the Promise of All-Payer Claims Databases

Editor’s Note: America spends more on health care per person than any other developed country, only to have the lowest life expectancy among them. Despite our expenditures—now one out of every five dollars of national...more

Goodwin

Federal District Court Ruling May Jeopardize Insurance Coverage of More Than 50 Recommended Procedures, Screenings, and Treatments

Goodwin on

Under the Affordable Care Act, group health plans and health insurance issuers are required to provide health insurance coverage based on recommendations made by healthcare coverage professionals. The covered categories...more

Faegre Drinker Biddle & Reath LLP

Considerations for Entry or Reentry Into the Individual Health Insurance Market

Many health insurers and HMOs may be considering entering or reentering the individual health insurance market, either on or off a federal or state-based health insurance marketplace. Over the last two years, the individual...more

Troutman Pepper

Supreme Court Finds Insurers Entitled To Millions In ACA Payments

Troutman Pepper on

On April 27, the U.S. Supreme Court held that the federal government is on the hook for $12 billion it failed to pay insurers under the Affordable Care Act (ACA) risk-mitigation program known as the Risk Corridors Program. ...more

Rivkin Radler LLP

Supreme Court Rules in Favor of Health Insurers Under ACA Program

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On April 27, the U.S. Supreme Court ruled in favor of commercial health insurers that were seeking $12 billion under the Affordable Care Act’s risk corridor program, acknowledging that the ACA “obligated the government to pay...more

Epstein Becker & Green

Supreme Court: The ACA & Risk Corridor Obligations

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The U.S. Supreme Court decision in Maine Community Health Options v. United States, is a major decision affecting healthcare and resolving a significant Obamacare dispute. The Affordable Care Act famously established online...more

Sheppard Mullin Richter & Hampton LLP

Supreme Court Issues Long Awaited Ruling on Affordable Care Act Risk Corridors Program

The Supreme Court issued a long-awaited ruling on April 27, 2020, directed at a more than $12 billion challenge related to the temporary risk corridors program established by the Affordable Care Act (the “ACA”). Challenges...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Moda Health Plan, Inc. v. United States

On April 27, 2020, the U.S. Supreme Court decided Moda Health Plan, Inc. v. United States, holding that the Affordable Care Act requires the federal government to compensate insurers for significant losses their health plans...more

Seyfarth Shaw LLP

Supreme Court Rules Government Must Pay $12 Billion to Health Insurers Under ACA Risk Corridor Program

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On April 27, 2020, the US Supreme Court ruled by an 8-1 decision that the federal government must pay billions of dollars to health insurers who sold consumer policies on exchanges under the Affordable Care Act’s (“ACA”)...more

Locke Lord LLP

Supreme Court Rules 8-1 That Government Must Pay Health Insurers Under ACA Risk Corridor Program

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In a major win for health insurers, the U.S. Supreme Court ruled in an 8-1 decision that the federal government owes roughly $12.3 billion to health insurers who claimed losses under the risk corridor program of the...more

Stoel Rives LLP

COVID-19 Relief Legislation Contains Testing Mandate

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In the second major piece of legislation responding to the novel coronavirus (COVID-19) pandemic, the President signed the Families First Coronavirus Response Act (“Act”) into law on March 18, 2020....more

Ogletree, Deakins, Nash, Smoak & Stewart,...

An IRS Holiday Gift: 2019 Affordable Care Act Reporting Relief

The Internal Revenue Service (IRS) issued Notice 2019-63 on December 2, 2019 providing some relief from Affordable Care Act (ACA) reporting requirements. The notice provides relief consistent with that provided in the past...more

Schwabe, Williamson & Wyatt PC

Texas Federal District Court Opines That the Affordable Care Act Is Invalid in Its Entirety: Where Does It Go from Here?

On December 14, 2018, a federal judge in Texas, in response to a lawsuit brought by 20 Republican states, issued a judgment opining that the Affordable Care Act (“ACA”) is invalid in its entirety. That is a very sweeping...more

Bradley Arant Boult Cummings LLP

DOL Regulations on Association Health Plans: How Will They Affect the Health Insurance Marketplace?

Last year, the President issued an Executive Order directing the Secretary of the Department of Labor (DOL) to issue regulations to expand access to association health plans (AHPs). Earlier this year, the DOL issued final...more

Locke Lord LLP

Maryland Obtains Waiver for Health Reinsurance Program

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Maryland officials will formally announce Wednesday that the federal government has approved an ACA state innovation waiver intended to help shore up Maryland’s individual health insurance market, which has suffered from...more

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