Health Insurance

News & Analysis as of

Senate Passes NOTICE Act Regarding Observation Care

On July 29, 2015, the Notice of Observation Treatment and Implication of Care Eligibility (NOTICE Act) was approved by the U.S. Senate. The law will require hospitals to provide written notification to patients within 24...more

IREG Update - August 2015

Hot Topic: Re"visiting" the sharing economy - A primer on the insurance issues surrounding lodging sharing companies - Background Beginning in the early 2000's, social technologies enabled the emergence of new...more

Under the Dome: Inside the Maine State House

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. A Unanimous Decision - A sequence of events led to the creation of 65 controversial vetoes...more

Attempts to Force Votes on Employment Bills Fail in Senate

Before the Senate adjourned for the August recess, two Democratic members tried to force the chamber to agree to bring minimum wage, paid sick leave, and flexible scheduling bills to the floor for a vote in the fall. On...more

Limiting an Employee’s Hours to Avoid Offering Group Health Plan Coverage Under the Affordable Care Act: Evaluating the Risks...

Business leaders and human resources and employee benefits professionals are well aware of potential minefields for employer group health plan sponsors under the Affordable Care Act (ACA). Large employer plan sponsors are...more

Obama Administration Finalizes Regulations on ACA Coverage of Preventive Services, Including Contraceptive Services

The Obama Administration published final regulations on July 14, 2015 that implement Affordable Care Act requirements regarding coverage without cost sharing of certain preventive services, including contraceptive services....more

Kane v. Healthfirst and the 60-day Repayment Rule

Case: Kane v.Healthfirst, Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., case number1:11-cv-02325, in the U.S. District Court for the Southern District of New York. As part of the Affordable Care Act...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers: The Basics (Part 3 of 24)

Alden Bianchi, Chair of Mintz Levin’s Employee Benefits & Executive Compensation Practice, will provide a weekly installment on the complex reporting obligations outlined by the Affordable Care Act for health insurance...more

Manatt on Health Reform: Weekly Highlights - August 2015

Increased plan choice on HealthCare.gov is linked to lower premium growth; Arizona seeks changes to Medicaid expansion; and California and New York release detailed Marketplace and Medicaid enrollment reports....more

Is Your Health Plan HIPAA Compliant?

Data breaches with respect to medical information are on the rise, given that such information is generally more valuable on the black market than stolen credit card data. The 2015 breach of healthcare company Anthem, Inc.,...more

Be Alert Middle East: New Dubai and Qatar Health Insurance Laws

Qatar, and most recently Dubai, have introduced a compulsory health insurance scheme. The scheme, which applies to all residents and visitors, stipulates that it is mandatory for employers to provide employees with health...more

ACA Information Reporting Penalties Have Been Increased

Code Sections 6055 and 6056 require large employers and all employers (even small employers) sponsoring self-funded health plans to file information returns with the IRS and furnish statements to applicable employees...more

Is PPACA on the Road to Recovery?

Part I: Is PPACA on the Road to Recovery? The recent decision in King v. Burwell by the Supreme Court of the United States sent a strong message to critics of the Patient Protection and Affordable Care Act of 2010...more

Employee Benefits Alert - July 2015

Major Revisions to Qualified Plan Determination Letter Process Announced - Effective January 1, 2017, the staggered five-year determination letter remedial amendment cycles for individually designed plans will be...more

Wal-Mart Accused of Gender-Discrimination Because of Anti-Gay Insurance Policies

In Cote v. Wal-Mart Stores, Wal-Mart is facing the possibility of a class action suit from a former employee who claims that the company’s denial of healthcare benefits to her same-sex spouse amounts to sex discrimination....more

New IRS Guidance on 40% Excise Tax Previews Future Regulatory Complexity

Although public opposition to the 40% excise tax on high-cost health care is rapidly growing, the IRS continued to develop a regulatory framework for administration of the excise tax through its issuance of Notice 2015-52 on...more

Payment is due at the time services are rendered

Typically, physicians collect co-payments from patients when services are provided, submit claims for reimbursement to government and commercial payers, and then send bills to patients for the balance owing. The payment and...more

SEE YOU IN COURT – July/August 2015

Mr. Superintendent couldn’t believe that it is already again time for negotiations with the Nutmeg Union of Teachers (NUTS). However, when Mr. Superintendent told Mr. Chairman that teacher negotiations are coming up and...more

Final Rules for Preventive Services

The U.S. Departments of Treasury, Labor (DOL) and Health and Human Services (HHS) have issued interim final regulations and Frequently Asked Questions and Answers on the cost-free coverage of preventive services under the...more

When Is a Hospital Not a Hospital?

Rebecca was a nurse at North Cypress Medical Center, in Texas. Back in 2011 she was treated for an eating disorder at Timberline Knolls Residential Treatment Center, in Illinois. When she sought reimbursement under the...more

Governor Rauner and AFSCME Extend Master Agreement, But Only Through September

Earlier this week, Governor Rauner and AFSCME Council 31, the union representing almost 40,000 state workers, agreed to temporarily extend the terms of the 2012-2015 collective bargaining agreement (CBA) and prohibit a strike...more

Employee Benefits After Obergefell

In a historic decision, the United States Supreme Court in Obergefell v. Hodges recently held that the Fourteenth Amendment of the United States Constitution requires all jurisdictions in all fifty states to: (1) license a...more

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

CMS offers a special enrollment period for HealthCare.gov enrollees whose incomes were miscalculated due to system error; California Marketplace announces two new insurers; and Connecticut’s budget reduces eligibility levels...more

Are Wellness Programs Worth It?

Please see Chart below....more

Health Care Update - July 2015 #3

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

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