Health Insurance

News & Analysis as of

New Notice Requirements For Employer Wellness Programs

Employers who sponsor employee wellness programs must plan now to comply with a new notice requirement that takes effect soon. Beginning with the first plan year on or after January 1, 2017, employers sponsoring wellness...more

Federal Government Sued Over Emergency Physician Reimbursement Policy

Emergency physicians have long alleged that health insurance companies are unfairly and inconsistently setting low out-of-network reimbursements for emergency care, and now they are imploring the federal government to do...more

It’s Marketplace Appeal Season!

All of us of a certain age remember the Bugs Bunny cartoon in which Bugs and Daffy confused dimwit Elmer Fudd as to the current hunting season – i.e., wabbit (Bugs) or duck (Daffy) – ending with the proclamation of baseball...more

Major Changes To Nondiscrimination Requirements Under ACA Effective Soon: Are Covered Entities Ready?

The HHS Office of Civil Rights (“OCR”) published a final rule May 18, 2016, broadening the nondiscrimination requirements applicable to all health programs and activities receiving federal financial assistance from HHS, those...more

When Settlement and Secrecy Do Not Mix

Non-disclosure and confidentiality provisions can be an important aspect of resolving a case through settlement. But when one of the parties is a purported class, and the allegation is an antitrust violation, settlement and...more

Connecticut Legislative Update: Public Act 16-77: An act concerning patient notices, designation of a health information...

This legislation (P.A. 16-77) makes substantive and technical changes related to Public Act 15-146, a major public health and health care bill passed by the Connecticut Legislature during its 2015 Legislative Session....more

Manatt on Health Reform: Weekly Highlights - June 2016 #5

Kentucky proposes premium assistance and high deductible health plans to cover expansion enrollees under an 1115 waiver; New York Legislature expresses unanimous support for a reimbursement increase for safety-net hospitals;...more

Another One Bites the Dust: Maryland Federal District Court Dismisses Putative Data Breach Class Action for Lack of Standing

The United States District Court of Maryland recently dismissed a putative class action alleging that CareFirst’s failure to adequately secure the computer hardware storing their customers’ personal information led to two...more

Issue 100: Agencies Propose ACA Regulations on Expatriate Plans and Excepted Benefits

This is the one-hundredth issue in our health care reform series of alerts for employers on selected topics in health care reform. (Our general summary of health care reform and other issues in this series can be accessed by...more

Health Insurer Mergers Draw Regulatory Opposition

In July 2015, Aetna announced its intention to acquire Humana, followed later that month by Anthem's announcement that it was acquiring Cigna. The deals are the largest insurance mergers ever proposed, and if consummated,...more

California Insurance Commissioner Asks DOJ to Block Proposed Mergers

On June 23, 2016, California Insurance Commissioner Dave Jones submitted a letter urging the Department of Justice, Antitrust Division (DOJ) to block the proposed merger between Aetna, Inc. (Aetna) and Humana, Inc. (Humana). ...more

Republican Alternative to the Affordable Care Act Addresses the McCarran Ferguson Act's Antitrust Exemption

On June 22, Republicans in the House of Representatives announced a new proposal to "repeal and replace" the Affordable Care Act. While not formal legislation, the proposal – a 37-page policy statement entitled "A Better Way"...more

Deadline Reminder for Employers and Providers: Electronically File Information Returns with IRS by June 30

Self-insured employers, applicable large employers and health coverage providers are reminded that the June 30 deadline to electronically file information returns with the IRS is approaching. The deadline to provide...more

NC Legislative Update - June 2016 #4

Last Week - It appears that House and Senate leadership will keep their word on adjourning before the 4th of July, with leadership of the two chambers apparently agreeing to a budget over the weekend. The Senate worked...more

HHS Issues Final Rule On Nondiscrimination In Health Programs And Activities

On May 18, 2016, the United States Department of Health and Human Services ("HHS") Office for Civil Rights ("OCR") issued a Final Rule implementing Section 1557 of the Affordable Care Act ("ACA"), which prohibits...more

Obama Administration Asks Court to Dismiss ACA Risk Corridor Litigation

Yet another challenge is being brought against the Affordable Care Act (ACA), this time regarding the ACA's risk corridor program. The first of several lawsuits over this program was filed in February 2016 by an Oregon health...more

CA Insurance Commissioner Urges U.S. Justice Department to Block Merger of Aetna and Humana

The proposed $37 billion merger of health insurance giants Aetna and Humana has faced several regulatory and antitrust hurdles since it was announced in July 2015. Aetna’s proposed acquisition of Humana also coincides with...more

Maryland Co-Op Claims Risk Adjustment Formula Discriminates Against Smaller Insurers

Maryland’s Evergreen Health Cooperative has filed for an injunction against the federal government to halt payment by the Consumer Operated and Oriented Plan (co-op) of the $22 million it owes to CareFirst BlueCross...more

Illinois data breach law amended and includes new twists

Governor Bruce Rauner signed several new provisions into law amending Illinois’ Personal Information Privacy Act, including health insurance and medical information into the definition of personal information that triggers...more

COBRA Notices May Include Additional Information on Exchanges

The Department of Labor (DOL) recently issued an FAQ addressing the inclusion of information about the Health Insurance Exchanges (Marketplace) in COBRA notices. The guidance could be very helpful for employers in directing...more

Transitioning to Coverage: Three Things to Know About the New Transgender Healthcare Regulations

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations implementing the nondiscrimination provisions of the Affordable Care Act. As we discussed in our March 30, 2016 blog, the rule...more

Tribal Employment and Jobs Protection Act Seeks to Exempt Native American Tribes from ACA

The Tribal Employment and Jobs Protection Act (H.R. 3080) could have a big impact on tribes if it becomes law. The legislation, which was passed by the U.S. House Ways and Means Committee June 15, seeks to exempt Native...more

HHS Issues Final Rule on ACA Nondiscrimination in Health Programs and Activities

On May 18, 2016, the Department of Health and Human Services (“HHS”) issued final regulations interpreting the nondiscrimination provisions of Section 1557 of the Affordable Care Act (“ACA”). The rule mainly impacts insurers...more

DOJ and North Carolina Challenge Anti-Steering and Tiering Provisions in Managed Care Contracts

The Department of Justice’s antitrust division (the “DOJ”)and the State of North Carolina (“NC”) jointly sued, on June 9, 2016, Carolinas HealthCare System (“CHS”), the largest healthcare system in North Carolina, over...more

HHS Final Rule Finds Categorical Exclusions for Health Services Related to Gender Transition Are Generally Unlawful

The U.S. Department of Health and Human Services (HHS) recently published its Final Rule implementing Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the basis of, among other grounds, sex in...more

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