Health Insurance

News & Analysis as of

Your Oregon Legislature in Action - Employers Face Statewide Sick Leave, “Ban the Box” and More

An onslaught of bills affecting employers were introduced during the 2015 legislative session. Much of the Legislature’s time was spent crafting a statewide sick leave bill with the result that many of the proposed bills...more

AmerisourceBergen Guest Post: Solutions to Overcome Reimbursement Challenges in Personalized Medicine

The continued development and refinement of personalized medicine (PM) has offered an opportunity to revolutionize medical practice and improve outcomes by providing treatments for patients with the notion that “this drug is...more

The ERISA Litigation Newsletter - August 2015

Editor's Overview - As the summer draws to a close, this month's Newsletter previews three cases that the U.S. Supreme Court already has agreed to hear that ought to be of particular interest to ERISA plan sponsors and...more

PERC Decision Lays Groundwork for Negotiations Once Chapter 78 Contributions are Fully Implemented

New Jersey’s Public Employee Relations Commission (“PERC” or the “Commission”) has weighed in on the issues of (1) when health insurance contributions become negotiable once the fourth tier of contributions under Chapter 78...more

OIG Approves Limited, Free Drug Program

On August 12, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-11, approving two pharmaceutical manufacturers’ free starter drug program. Citing the limited scope...more

The Impact Of Obergefell On Employee Benefits

Prior to the Obergefell decision, the U.S. Supreme Court, in U.S. v. Windsor, struck down Section 3 of the Defense of Marriage Act (DOMA), which mandated that federal laws only recognize opposite-sex marriages. As a result of...more

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

Arkansas's “Private Option” is projected to have a net impact of $438 million on state funds 2017-2021; Iowa selects MCOs for proposed Medicaid managed care transition; and, the DC Marketplace launches a robust dual-language...more

OIG Issues Advisory Opinion Regarding Pharmaceutical Manufacturers’ Program to Provide Free Limited Drugs to Beneficiaries When...

On August 12, 2015, the Department of Health and Human Services Office of Inspector General (OIG) posted Advisory Opinion No. 15-11, finding that a program to supply a limited amount of free cancer drugs to federal health...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 6 of 24): Reporting Group Health Plan Opt-Out...

Under a common strategy for controlling group health care plan costs, employers sometimes adopt arrangements under which an employee is offered cash as an incentive to waive coverage. These arrangements are colloquially...more

Health Alert (Australia) - August 24, 2015

In This Issue: - Judgments; Legislation; and Reports. - Excerpt from Judgements: Victoria 17 August 2015 - Bourke v Coroners Court [2015] VSC...more

The Scoop on MOOP: McGuireWoods Healthcare Reform Guide: Installment No. 53

This is the 53rd 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

IREG Update - August 2015 #2

Hot Topic: New York Emergency Medical Services and Surprise Bills Law - Earlier this year, New York’s Emergency Medical Services and Surprise Bills Law went into effect (the full text of the bill is available on the...more

The “Cadillac Tax” is Rollin’ In!

When healthcare reform was rolled out in 2010, there was a provision included in the law imposing a tax on healthcare benefits provided to employees that exceed a threshold cost. This tax has been referred to as the...more

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

Ohio’s Medicaid expenditures came in $2 billion below estimates despite enrollment growth after Medicaid expansion; California extends full Medicaid benefits to more pregnant women; and nearly one million have enrolled in...more

Waivers of Co-Pays and Deductibles: Insurance Benefit Exclusions Grow

Recent changes to policy and plan language and increased litigation by third-party payers suggests that out-of-network providers who waive co-pays and deductibles may be in for some rough sailing. Providers must be aware of...more

A First Step on a Long Road: CMS Begins Implementation of ACA Transparency Standards

On August 11, 2015, the Centers for Medicare and Medicaid Services (CMS) posted for public comment notice of a new required data collection for health insurers. Its purpose is to begin the implementation of section 1311 of...more

The Future of Healthcare Discrimination Litigation-Section 1557 of the ACA

This article was originally published by American Health Lawyers Association. Copyright 2015, American Health Lawyers Association, Washington, DC. Reprint permission granted. It is no secret that the Affordable Care Act...more

New Final Regulations and FAQs Provide Guidance on Preventive Services Coverage

Through new FAQs and final regulations, the U.S. Departments of Labor (“DOL”), Health and Human Services (“HHS”) and the Treasury (the “Departments”) have further clarified various issues related to the preventive care...more

IRS Issues New Forms for ACA Reporting; Congress Increases Penalties for Failure to Meet Requirements

The IRS has completed drafts of the 2015 forms and instructions for employers, insurers, and other health plan sponsors to use to meet their reporting obligations for the employer and individual mandates under the Affordable...more

Increased Penalties for Information Returns

On June 29, 2015 the penalties under Code section 6721 and 6722 for failures relating to the filing of information returns required by numerous sections of the Code, including the ACA's new reporting for health coverage...more

Second Circuit holds that the Affordable Care Act does not violate the Religious Freedom Restoration Act

On August 7, 2015, in Catholic Health Care System v. Burwell, the Second Circuit Court of Appeals held that the Religious Freedom Restoration Act (“RFRA”) is not violated by certain regulations promulgated under the...more

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

Reductions in uninsured rates are greatest in states with Medicaid expansions and State-based or State Partnership Marketplaces; Kentucky finds increased use of preventive healthcare following Medicaid expansion; and,...more

The ACA and Staffing Agency Workers

Companies that use staffing agencies to supply workers face special issues in determining their risk for the significant penalties under the Affordable Care Act’s “play or pay” rules....more

NC Legislative Update - August 2015

This Week - It was an eventful week at the General Assembly and perhaps the most noteworthy news on Jones Street took place on Wednesday. Senate leadership held a press conference announcing that they were willing to...more

Ask Fisher & Phillips: Our Top 10 Questions From Dealers (Part Three)

This edition of “Ask Fisher & Phillips” picks up where our last newsletter left off – here is the concluding segment of the “Top 10 Questions from Dealers” from the past year....more

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