News & Analysis as of

Washington Healthcare Update

This Week: Energy and Commerce Hearing Examines ICD-10 Preparedness... HHS Announces Oncology Care Model Initiative... Pennsylvania Governor Abandons Alternative Medicaid Expansion Approach for Traditional Plan....more

Eligibility Rules Need To Be In Writing

Healthcare reform continues to roll on. 2014 saw the implementation of the health insurance exchanges, the Individual Mandate, and a host of new rules relating to employer-provided health coverage. 2015 marks the start of yet...more

IRS Publishes Final Forms and Instructions on Information Reporting Under the Affordable Care Act

The Internal Revenue Service (IRS) published final forms and instructions addressing information reporting requirements applicable to employers and insurers under Internal Revenue Code Sections 6055 and 6056. The reporting...more

IRS Finalizes Forms and Instructions for ACA Information-Reporting Requirements

For the 2015 calendar year, the Patient Protection and Affordable Care Act of 2010 (“ACA”) imposes information-reporting requirements on health insurance issuers and employers. Insurers and employers are required to report to...more

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

HHS ramps up for the final week of open enrollment. Families buying into CHIP in Pennsylvania are granted tax relief, and though Medicaid expansion efforts seem to have hit a wall in Tennessee and Wyoming, Arkansas assures...more

News from the Health Law Gurus™

Millions Affected by Hackers’ Attack on Health Insurer Anthem, Inc. – “Anthem was the target of a very sophisticated external cyber attack,” announced Joseph Swedish, Anthem’s President and CEO. Anthem, Inc., formerly...more

Not All Health Savings Plans Are Created Equal

Health Savings Accounts (HSAs) have gained in popularity since the implementation of the Affordable Care Act, but many employers are unclear about how they differ from more traditional Flexible Spending Accounts (FSAs). An...more

Obama Administration Releases FY 2016 Budget Proposal with Medicare/Medicaid Provisions

On February 2, 2015, the Obama Administration released its proposed federal budget for fiscal year (FY) 2016. The budget would impact all types of health care providers, health plans, and drug manufacturers if adopted as...more

Manatt on Health Reform: Weekly Highlights - February 2015

The President’s budget reveals the healthcare agenda for his Administration’s penultimate year. Medicaid expansion proposals advance in Arkansas and Wyoming; California’s Marketplace reports 9 out of every 10 enrollees remain...more

Iowa Insurance Commissioner Petitions for Liquidation of Iowa/Nebraska CO-OP; How Financially Sound Are Others?

The Iowa Commissioner of Insurance (the “Commissioner”) filed a petition, on January 29, 2015, seeking to liquidate CoOpportunity Health, Inc. (“CoOpportunity”), a Consumer Operated and Oriented Plan (“CO-OP”) established...more

Top 10 Topics for Directors in 2015: Explore New Trends in Reducing Corporate Health Care Costs

The increasing cost of healthcare is a significant concern for companies that provide health care benefits to their employees. With certain key provisions of the Patient Protection and Affordable Care Act, more commonly known...more

Congress Clarifies the Expatriate Health Coverage Exemption

For expatriate health plans issued or renewed on or after July 1, 2015, the Expatriate Health Coverage Clarification Act of 2014 (EHCCA) provides an exemption from various Affordable Care Act (ACA) provisions. Last December,...more

Indiana Wins Federal Approval to Expand Medicaid Coverage Under Obamacare

Republican Indiana Gov. Mike Pence announced on Tuesday that an agreement had been reached on the state’s Medicaid expansion proposal submitted in July. As many as 350,000 people could gain coverage under the federal health...more

QNHII Regs Due Thursday—After Only Five Years

When the Affordable Care Act (ACA) was signed into law back in 2010, it directed the Centers for Medicare & Medicaid Services (CMS) to establish the Consumer Operated & Oriented Program (CO-OP). The point of the CO-OP is to...more

Manatt on Health Reform: Weekly Highlights #4

This week, the IRS announces relief for some taxpayers who received excess advanced premium tax credits; Indiana and Arkansas make major announcements on Medicaid expansion and Iowa’s Governor announces a shift towards...more

Three Factors Affecting the Mid-Level Practitioner Workforce, Part One

As more Kentuckians gain access to health care as a result of the Affordable Care Act, healthcare workforce shortages for primary care providers becomes problematic particularly in rural Kentucky. Never before have mid-level...more

Agencies Green Light Pilot Program to Allow Limited Wrap-Around Coverage for Health Insurance Policies Purchased on an Exchange

Under proposed rules recently issued by the Departments of Treasury, Labor, and HHS, employers may participate in a pilot program where they offer certain wraparound coverage as an “excepted benefit” to part-time employees,...more

New Proposed Rules Streamline ACA Summary of Benefits and Coverage (SBC) Disclosure Requirement

In a very welcome development for health insurance issuers and employers who sponsor self-funded group health plans, the Departments of Treasury, Labor, and HHS have issued joint new proposed regulations that will streamline...more

2015 Health Care Reform Compliance Checklist for Employers

The United States has entered a new era of health care reform. Until now, United States employers were generally not required to provide health care coverage to employees (although many did so for employee relations and...more

Weekly Update Newsletter - January 2015 #2

GOVERNMENT CONTRACTS - HHS IG Issues Report Regarding Federal Marketplace: Inadequacies in Contract Planning and Procurement - The Department of Health and Human Services (HHS) inspector...more

Caution: Big Penalties for Reimbursing Health Care Premiums

Even if you are a small employer who is not required to provide your employees with health insurance under the Affordable Care Act (ACA), if you reimburse your employees for health insurance premiums, you run the risk of...more

House Approves Bills to Modify ACA Rules for Employers Related to Part-Time Workers, Veterans

On January 8, 2015, the House of Representatives approved H.R. 30, the “Save American Workers Act.” The legislation would amend the ACA’s definition of “full-time employee” for purposes of the requirement that certain...more

Administration Issues Proposed Rules on ACA Summary of Benefits and Coverage, Excepted Benefits/Wraparound Coverage

On December 30, 2014, the Internal Revenue Service (IRS), the Employee Benefits Security Administration (EBSA), and the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise Affordable...more

Small Nonprofit? Get the Credit You Deserve!

In March 2010, the Affordable Care Act was enacted to encourage small businesses and tax-exempt organizations to offer health insurance to their employees for the first time or continue the health care coverage they already...more

Health Headlines: Also in the News - January 2015 #2

House Passes Bill to Redefine Full-Time Employee Under ACA – On January 8, 2015, the House of Representatives in a 252-172 vote approved a bill that would redefine a full-time worker under the ACA employer mandate from one...more

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