News & Analysis as of

Health Insurance

GOP senators’ Trumpcare: Meaner in many ways than even House plans

After weeks of huddling in partisan secrecy, majority Republicans in the U.S. Senate have coughed up what they’ve dubbed the Better Care Reconciliation Act, aka their version of Trumpcare....more

The Better Care Reconciliation Act: Similarities to House Health Care Bill, Preserves Parts of ACA

by Bass, Berry & Sims PLC on

On June 22, 2017, Senate Republicans released a draft of the Better Care Reconciliation Act (BCRA), their much-anticipated version of the legislation to "repeal and replace" the Affordable Care Act (ACA). Despite rumors of a...more

Why Isn’t My “Free” Preventive Health Care Free?

by Snell & Wilmer on

In my opinion, one of the best changes made by the Affordable Care Act is the mandate that requires health plans to provide certain specified preventive services without imposing any cost sharing. This is sometimes referred...more

Exclusive Agreement Between Hospital and Insurance Plan Does Not Violate Section 1

The Seventh Circuit refused to revive an exclusive dealing claim by one hospital against its competitor because of an exclusivity agreement with an insurance plan. Judge Richard Posner wrote the short opinion strongly...more

Senate Republicans Release Bill to "Repeal and Replace" the Affordable Care Act

by Littler on

On June 22, 2017, Senate Republicans released a draft of their legislation to repeal and replace the Affordable Care Act (“ACA”). After the House narrowly passed its version of ACA overhaul legislation, the American Health...more

Senate Healthcare Bill Released for Public Review

Just over four weeks after the Congressional Budget Office (CBO) released its score of the American Healthcare Act (AHCA), the bill passed by a narrow margin in the U.S. House of Representatives, the U.S. Senate released ‘The...more

Senate GOP’s Health Care Plan Reshapes House’s Bill to Repeal and Replace the Affordable Care Act

by Epstein Becker & Green on

When the House of Representatives narrowly passed H.R. 1628, the American Health Care Act (AHCA), and shipped it across the Capitol for the Senate’s consideration, key senators said they intended to write their own bill...more

Hull Speed, Codgers, and Pre-Existing Conditions: What Does the Senate Bill Do?

by Balch & Bingham LLP on

Many other things being equal, the longer the sail boat, the faster it can go before its bow wave defeats further speed increase. However, as any boat approaches its “hull speed,” an increasing amount of energy is required...more

Are You Ready for AB 72?

by Buchalter on

To protect patients from receiving an unexpected surprise bill when they seek care at in-network facilities from out-of-network providers, Governor Brown signed AB 72: California’s surprise out-of-network law. The new law...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

Employers Permitted to Modify Retiree Benefits Following Expiration of CBA

In a closely watched case for employers, the Third Circuit Court of Appeals, which has jurisdiction in Pennsylvania, New Jersey, Delaware and the U.S. Virgin Islands, recently held that retiree healthcare benefits provided in...more

Seventh Circuit Finds Exclusive Dealing in Hospital-Payer Case Pro Competitive

“But what is more common than exclusive dealing?” Affirming summary judgment for defendant Saint Francis Medical Center, the Seventh Circuit recently held that the hospital’s contracts with health care insurers—though...more

When your Hospital-of-Choice is In-Network but, SURPRISE, your Anesthesiologist is Not: California’s AB-72 and Other State...

Regardless of a patient’s diligence in selecting an in-network hospital, ambulatory surgery center, or other health facility for treatment, patients are still being saddled with surprisingly high medical bills that include...more

Iowa Submits Sweeping 1332 Waiver Seeking Emergency Relief

Overview - On June 12, Iowa submitted a sweeping Section 1332 waiver that would replace the Affordable Care Act’s (ACA) premium tax credits with a new state-administered tax credit and a reinsurance program. The state tax...more

PCORI Fee Due by July 31, 2017

by McDermott Will & Emery on

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

Repeal of the Affordable Care Act Will Not Include Changes to Tax Exempt Hospitals’ 501(r) Charitable Care Obligations

While the Senate Budget Committee works to draft legislation to reconcile the American Health Care Act, the repeal and replace bill passed by the House, there is no expectation of a repeal of the charitable care obligations...more

Health Alert (Australia) 19 June 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 9 June 2017 - Health Services Union v St John of God Health Care [2017] FWC 2981 - Alleged dispute arising under an enterprise...more

Congressional Budget Office Releases Report on American Health Care Act

by King & Spalding on

On May 24, the Congressional Budget Office (CBO) released its analysis - or “score” - of H.R. 1628, the American Health Care Act (AHCA), as passed by the House on May 4, 2017. The CBO score projects that the AHCA would...more

What’s the Senate hiding on health care bill?

Bernie Sanders recently offered on Twitter what he described as a display of all the Senate Republicans’ public considerations of the American Health Care Act, aka Trumpcare: a photo of a blank piece of paper....more

The Rise of the Group Health Insurance Captive

With its “employer mandate”—i.e., the requirement that applicable large employers make an offer of group health coverage to substantially all full-time employees or face the prospect of a penalty—the Affordable Care Act (ACA)...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

California Legislative Update: Several Labor and Employment Bills Passed in the Assembly

Several California labor and employment law bills passed in the state assembly or senate before the June 2, 2017, legislative deadline. The legislature now has until September 15, 2017, to pass these bills in the second...more

Health Alert (Australia) 12 June 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 7 June 2017 - Al Muderis v Duncan (No 3) [2017] NSWSC 726 - DEFAMATION – assessment of damage – highly respected orthopaedic...more

Golden State Worriers: California Labor & Employment Bills to Watch

by Littler on

When it comes to legislation, for California employers it's the final countdown. June 2 was the last day for bills to pass out of their house of origin. September 15 is the deadline for these bills to pass both legislative...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

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