News & Analysis as of

Health Insurance Dept. of Health and Human Services

New Guidance on Coverage for Eating Disorders

by Tucker Arensberg, P.C. on

The Departments of Labor, Treasury, and Health and Human Services recently released a frequently asked question (“FAQ”) regarding the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction...more

OIG Initiates Monthly Updates to its Work Plan and Adds New Items

by King & Spalding on

The HHS Office of Inspector General (OIG) recently announced that, effective June 15, 2017, the agency will update its Work Plan website monthly instead of only once or twice per year. In developing its Work Plan, OIG...more

HHS Cannot Pause United’s Challenge to the Medicare C/D Overpayment Rule

by King & Spalding on

As previously reported, UnitedHealthcare Insurance Company (United) is challenging CMS’s Medicare C/D Overpayment Rule as it applies to Medicare Advantage (MA) organizations. HHS sought to stay United’s lawsuit while it...more

CMS Seeks Recommendations On How To Regulate Individual and Small Group Health Insurance Markets

by King & Spalding on

On June 8, 2017, CMS issued a statement announcing a request for information (RFI) seeking recommendations and input from the public “on how to create a more flexible, streamlined approach to the regulatory structure of the...more

Health Care Reform Weekly Roundup – Issue 5

The Senate’s health care reform bill was released today, and we will report on that separately. In the meantime, below are key health care reform developments from the week of June 12th....more

Privacy Tip #92 – Finally, HHS is Removing SSNs From Medicare Cards

For those of you who know me, you know that I have been very frustrated with the federal and state governments for continuing to use Social Security numbers for eligibility, enrollment and participating in Medicare and...more

As ACA Repeal/Replace Debate Drags On, Trump Seeks Advice on How to Make Improvements to Health Care Markets

by Reed Smith on

In a tacit acknowledgement of the hurdles ahead for enactment of Affordable Care Act (ACA) repeal/replace legislation, the Trump Administration is soliciting suggestion for changes that could be made within the current legal...more

FY2018 Massachusetts Budget Update: Final Senate Budget

On May 25, 2017, the Massachusetts Senate unanimously approved a $40.84 billion FY2018 budget by a 38-0 roll call vote. Over three days of debate, Senators considered 1,031 amendments to the budget proposed by the Ways and...more

Manatt on Health Reform: Weekly Highlights - May 2017 #5

CBO says the House repeal and replace bill could destabilize the individual insurance market in some states; Indiana posts a work requirement amendment to its Medicaid expansion waiver application; and states allow insurers...more

2017 Minnesota Legislature Adjourns But After Special Session

by Stinson Leonard Street on

Minnesota lawmakers used every last minute available to them to try and complete their work prior to the deadline for the 2017 legislative session, but it was not enough time. At 12:01 a.m. early last Tuesday morning,...more

CMS’ New Interpretations And Guidance Relating To The Rules Governing The Affordable Care Act

by Stoel Rives LLP on

While H.R. 1628, the American Health Care Act of 2017, the bill that seeks to repeal key provisions of the Patient Protection and Affordable Care Act (“PPACA”), passed the House on May 4, 2017, and is being considered by the...more

FY 2018 President’s Budget May Signal Challenges for Health Programs on the Horizon

by McDermott Will & Emery on

Eric Zimmerman, along with McDermott+Consulting Vice Presidents Adaeze Enekwechi and Piper Su, wrote this +Insights publication detailing the possible effects of the Trump Administration's 2018 budget on health programs and...more

Manatt on Health Reform: Weekly Highlights - May 2017 #3

Governors pen bipartisan letter to Congress urging five-year extension of funding for the Children's Health Insurance Program (CHIP); new analyses find Medicaid funding cuts under the AHCA would disproportionately affect...more

Blog: House Passes AHCA; Senate Says “Not So Fast”

by Cooley LLP on

Last week, the House of Representatives passed the American Health Care Act (AHCA) by a razor-thin margin of 217-213. No Democrats supported the bill and 20 Republicans voted against it. Recall in March, the House was forced...more

ACA Brief: Path to Repeal - House Resuscitates the AHCA

This ACA Brief is the fifth in a series of installments that will closely track congressional and administrative actions relating to ACA provisions that affect large employer-sponsored plans. On May 4, 2017, the US House...more

Recent $2.5 Million OCR Settlement Is a Warning to Wireless Health Service Providers

by McDermott Will & Emery on

On April 24, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a Health Insurance Portability and Accountability Act of 1996 (HIPAA) settlement in the amount of $2.5 million based on...more

For Health Insurers, Court Decisions Continue to Complicate Risk Corridors Program Payments

by Faegre Baker Daniels on

For health insurers concerned about when they may receive government payments through the Affordable Care Act’s (ACA) risk corridor program, court decisions have provided little clarity. An April 18 decision by Judge Griggsby...more

Manatt on Health Reform: Weekly Highlights - May 2017

Florida, Maine and Ohio consider proposals to impose work requirements in Medicaid, Congress continues to debate the AHCA, and the uncertain future of cost-sharing reductions continues to generate concern....more

Manatt on Medicaid: Maine Releases Draft Waiver Request Proposing New Eligibility Requirements

On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more

Fate Uncertain for HHS’s Extension of ACA Discrimination Protections to Abortion & Gender Transition

by Genova Burns LLC on

In May 2016 HHS issued a final rule implementing the Affordable Care Act’s Section 1557 nondiscrimination provision, which applies to recipients of funding from HHS. The rule prohibits discrimination on the basis of gender...more

Final Market Stabilization Rules – How Stable is Stable?

The Department of Health and Human Services released the final Affordable Care Act marketplace stabilization rules (“Final Rule”) on April 13, 2017. The Final Rules become effective on June 19, 2017 and will, accordingly,...more

Stop-Loss Policies, How Low Can You Go?

by Bryan Cave on

On April 5, the “Self-Insurance Protection Act” passed the House and moved to the Senate. This bill, if enacted, would amend ERISA, the Public Health Service Act and the Internal Revenue Code (the “Big 3” statutes containing...more

HHS Finalizes Health Insurance Market Stabilization Rules

by Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) has finalized regulations designed to help stabilize the individual and small group health insurance markets and, in particular, the health insurance exchanges...more

Changes to Stabilize HealthCare.gov Have Implications for Employer Sponsored Health Plans

by Winstead PC on

We learn early on that for any action there is a reaction. On Friday, the Department of Health and Human Services released “Market Stabilization” final regulations that will impact group health plans as they plan for 2018....more

Issue 108: HHS Moves Ahead In Face of ACA Uncertainty

by Seyfarth Shaw LLP on

This is the one hundred and eighth 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

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