Health Insurance

News & Analysis as of

Washington Healthcare Update

This Week: Health Subcommittee Advances 21st Century Cures, Full Committee Action Scheduled…Senate Finance Committee Hearing: Chair Hatch to Launch New Initiative on Improving Chronic Care for Medicare Patients…Hawaii’s...more

IRS Provides Penalty Relief for Incorrect or Delayed Forms 1095-A

The IRS issued Notice 2015-30, which provides penalty relief for taxpayers who received an incorrect or delayed Form 1095-A. Form 1095-A is provided to all individuals who enrolled in health insurance coverage through the...more

New FAQs Regarding Preventive Services Under Healthcare Reform McGuireWoods Healthcare Reform Guide: Installment No. 49

This is the 49th 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

EEOC Issues Proposed Rule Addressing Employer Wellness Programs and the ADA

On April 20, 2015, the Equal Employment Opportunity Commission (“EEOC”) issued a proposed rule to amend the regulations and interpretive guidance implementing Title I of the Americans with Disabilities Act (“ADA”) as it...more

IREG Update

Commercial Accountable Care Organizations - Models of health care delivery are evolving on many fronts, driven by the overriding goals of lowering the cost of health care and increasing its quality. Traditional private...more

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

Latest numbers show dramatic post-ACA coverage gains; in California, an increase in dental-related ER visits follows cuts to Medicaid dental benefits; and the Massachusetts governor requests to maintain its definition of...more

House Bill Says 23 Years Isn’t Long Enough for Transition to ICD-10

All across the country hospitals have been bracing for the scheduled Oct. 1, 2015, transition from ICD-9 coding to ICD-10. It had been scheduled for Oct. 1, 2014, but the Protecting Access to Medicare Act of 2014 delayed it...more

What’s Up With Wellness Programs Anyway?

My personal interest in employer wellness programs increased a few months ago when my wife and I were offered significant health insurance premium savings through her employer by participating in such a program. We completed...more

Compensation and Benefits Insights – April 2015

On April 20, 2015, the U.S. Equal Employment Opportunity Commission ("EEOC") published proposed regulations addressing how employers can implement wellness programs that comply with the Americans with Disabilities Act...more

Guidance Clarifies Preventive Care Requirements

Recent guidance issued jointly by the U.S. Departments of Labor, Health and Human Services, and the Treasury clarifies how the Affordable Care Act's requirement to provide cost-free coverage for preventive care applies to...more

Surprise Bills Laws Enacted in California and New York

What Do They Mean for Providers? - Both California and New York have recently enacted so-called “Surprise Bills Laws” that require out-of-network providers to give notice to patients that a particular item or service...more

Medigap Insurer's Contract with Preferred Hospital Network Approved (Yet Again)

On April 22, 2015, the Department of Health and Human Services, Office of Inspector General (OIG) issued Advisory Opinion 15-05 [PDF], approving a Medigap insurer’s proposed contract with a preferred hospital network. The...more

Iowa Supreme Court Affirms Ruling for Health Insurer in Antitrust Dispute

In late February, the Iowa Supreme Court affirmed a lower court ruling in Mueller v. Wellmark, ending a seven year battle over whether the health insurer’s agreement with employers operating “self-funded” insurance plans to...more

Insurance Antitrust Legal News: Volume 4, Number 3

Auto Insurers Again Seek Dismissal of In Re Auto Body Shop Antitrust Litigation - In early March, the auto insurer defendants in the In re Auto Body Shop Antitrust Litigation renewed their motions seeking the dismissal...more

Maryland Legislative Update

On April 13, 2015 after the release of the traditional sine die balloons and streamers, the first General Assembly of the newly elected Governor Lawrence J. Hogan, Jr. concluded with much success. With bills awaiting...more

Manatt on Health Reform: Weekly Highlights - May 2015

This week Montana became the 30th state to expand Medicaid, and the battle over Medicaid expansion and uncompensated care reached a breaking point in Florida. Meanwhile, as the King v Burwell decision looms, Congress and...more

Quirky Question #259, The FMLA and the ADA: Joined at the Hip

Question: I work in my company’s HR department and we just had an employee ask for additional time off, even though we’ve already given the employee a bunch of time off we are required to under the FMLA. I wanted to...more

Federal Judge Rules BCBSM’s “Value of Blue” Report Did Not Disclose Hidden Fees

A federal judge in the case of Alma Products v. BCBSM recently agreed with arguments presented by Varnum that Blue Cross Blue Shield of Michigan's "Value of Blue" report did not reveal that it was charging hidden fees (often...more

Health Alert (Australia) - May 4, 2015

In This Issue: Judgments; Legislation; and Reports & Publications. Excerpt from Reports & Publications: Queensland. Office of the Health Ombudsman 24 April 2015 - Health Ombudsman releases third...more

Washington Healthcare Update

This Week: House E&C Releases Discussion Draft of 21st Century Cures Legislation Ahead of Legislative Hearing... FDA Finalizes Biosimilar Guidance Documents... CMS Updates Wage Index and Payment Rates for the Medicare Hospice...more

EEOC Issues Proposed Regulations On Wellness Programs

Last week, the U.S. Equal Employment Opportunity Commission (EEOC) officially published proposed regulations that provide employers guidance on implementing wellness programs that comply with the Americans with Disabilities...more

All or Nothing: Federal Court Decides Exclusion from ‘Some’ Patients Insufficient for Refusal to Deal Claim

A federal district court in the Eighth Circuit dismissed claims brought against a physician-hospital organization and an insurer alleging that the defendants violated federal antitrust laws by refusing to deal with certain...more

EEOC Proposes Rules for Employer Wellness Programs

In response to the increasing cost of providing group health coverage, employers have begun encouraging their employees to participate in wellness programs with the goal of improving overall employee health and reducing...more

Week In Review - May 2015

Budget Showdown - Governor Mark Dayton has expressed dismay at the direction lawmakers are veering in their budget plans. On spending state money, lawmakers are widening the chasm. The May 18 legislative...more

Some Good News For Small Employers with Employer Premium Payment Plans

Since the Affordable Care Act (the “ACA”) was enacted, many employers offered “employer payment plans” to effectively cover employee health insurance plans. Per IRS Notice 2013-54, however, employer payment plans are group...more

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