Healthcare Reform

News & Analysis as of

Health Care Update - September 2014 #2

In This Issue: - National Health IT Week Begins Today - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health Care...more

Employer Shared Responsibility Payments and Reporting Requirements Under the Affordable Care Act: Code Sections 6055 and 6056

Employer Shared Responsibility Penalties - There are two types of employer shared responsibility payments, also known as pay or play penalties, under the Affordable Care Act (ACA). The first penalty under Internal...more

Fatal Blow to Healthcare Reform? Courts split on federal tax credit

On July 22, 2014, two federal courts came down on opposite sides of an issue that may have far-reaching consequences about the future of the Patient Protection and Affordance Care Act ("PPACA"). At stake is whether the PPACA...more

Manatt on Medicaid: Arkansas—A Leading Laboratory for Healthcare Payment and Delivery Reform

Increasingly, states are moving beyond their traditional Medicaid programs to embrace new roles as leaders of statewide payment and delivery system transformation. The search for statewide solutions is fueled by cost...more

Medicare Bundled Payments Initiative and Oncology Care

According to Modern Healthcare’s “Interest Surges in Medicare Bundled Payment Initiative” article on July 31, 2014, enthusiasm for bundled pricing has been associated with the Medicare Bundled Payments for Care Improvement...more

Health Care Update - September 2014

In This Issue: - HealthCare.gov Hacking Breach - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health...more

U.S. Court of Appeals for the District of Columbia Circuit to Rehear ACA Subsidy Challenge

On September 4, 2014, the D.C. Circuit vacated a panel decision in Halbig v. Burwell (Civ. No. 14-5018) striking down the federal government’s provision of premium subsidies to individuals purchasing coverage through the...more

The Affordable Care Act—Countdown to Compliance for Employers, Week 16: So What, Exactly, is an “Offer of Coverage”?

Whether an employer makes the requisite offer of group health plan coverage is critical to the application of the Affordable Care Act’s employer shared responsibility rules as reflected in final implementing regulations...more

Health Care Reform Implementation Update

As summer rolls to a close, the agencies continue to make announcements and roll out additional regulations. The Department of Health and Human Services (HHS) introduced the new CEO of Healthcare.gov, awarded grants to 147...more

Telehealth Bills Introduced in the 113th Congress

Telehealth Bills Introduced in the 113th Congress: - H.R. 28, Working Families' Access to Healthcare Innovations Act of 2013, introduced 1/3/2013: Allows the Small Business Administration to guarantee up to 90%...more

D.C. Circuit Court of Appeals Agrees to Hear Halbig ACA Case Before Full Court

Following up on our Week 22 ACA Countdown to Compliance post, the D.C. Court of Appeals granted the government’s petition for en banc review in Halbig v. Burwell, which held low income subsidies to purchase coverage through...more

Health Reform News - September 2014

In a surprising reversal, the U.S. Circuit Court of Appeals for the District of Columbia yesterday granted request by the federal government to have its full 11-judge bench re-hear the case on whether the government, by...more

Telehealth and Health IT Policy: Considerations for Stakeholders

In recent months, as the conversation about reforming the health care system has shifted to achieving greater delivery system efficiencies, cost containment, and patient satisfaction, the role of health care...more

Getting the Best Medical Care: a Newsletter from Patrick Malone - August 2014

In This Issue: - One Consumer's Story - Why Were You Denied? - Preparing for a Successful Appeal - Getting Help - Persistent Consumer Wins Big - Excerpt from Introduction: When Your Health Insurer...more

Manatt on Medicaid: Pennsylvania Receives Federal Approval to Implement Medicaid Expansion

On August 28, 2014, the Centers for Medicare and Medicaid Services (CMS) approved Pennsylvania’s application under Section 1115 of the Social Security Act to implement a Medicaid expansion effective January 1, 2015, through a...more

IRS Guidance on the Application of the Affordable Care Act’s Market Reform Provisions to HRAs and FSAs

The Internal Revenue Service (IRS) recently published guidance in Notice 2013-54 (the “Notice”) on the application of certain market reform provisions of the Affordable Care Act to Health Reimbursement Accounts (“HRAs”),...more

Federal Appeals Courts Issue Contradictory Rulings on Federal Marketplace Subsidies under Affordable Care Act

Two federal appeals courts issued contradictory rulings on the validity of subsidies for the purchase of health insurance under the federal marketplace established pursuant to the Affordable Care Act (ACA). On July 22, a...more

IRS Issues Draft Forms for Coverage Reporting Requirements under the Affordable Care Act

The Internal Revenue Service (IRS) has released draft versions of forms that will be used by employers to report health coverage information required under the ACA’s employer shared responsibility rules. As we have written in...more

Supreme Court Grants Injunction to Religious University Barring Strict Enforcement of Accommodation Scheme for ACA Contraception...

The United States Supreme Court granted Wheaton College, a religious non-profit college in Illinois, an injunction permitting the college to opt into the ACA contraception mandate’s accommodation scheme available to certain...more

News from the Health Law Gurus™

2019 Medicare Budget Reduced by $95 Billion – The New York Times is reporting that the projected Medicare budget for 2019 is $95 billion less than the projected budget for 2019 four years ago. According to the...more

Is CMS Feeling the Sunshine Heat?

As we told you about here, the Centers for Medicare & Medicaid Services (CMS) has been dealing with issues related to its Open Payments database of payments and transfers of value reported by manufacturers and group...more

Healthcare Reform in the U.S. Territories; Prepayment of Taxes for Puerto Rico Retirement Plans

The summer of 2014 has brought further guidance for health plan coverage in the U.S. territories and for retirement plan coverage in Puerto Rico. Issuers and employer sponsors of Puerto Rico group health plans and employer...more

Health Care Reform Implementation Update August 2014

The Centers for Medicare and Medicaid Services (CMS) made announcements this week regarding the Open Payments system and the availability of Affordable Care Act (ACA) Consumer Assistance Program grant funds, issued a request...more

Health Update - August 2014 #5

The Five Megatrends Shaping Pharma’s Next Decade: Sustaining Success in a New Market Landscape - Disruptive trends in the healthcare system will force companies to change their strategies. With new care models...more

Resistance WAS Futile—California Conforms to ACA Waiting Period Requirement

After wandering in the wilderness for a year, California has now come in from the cold and conformed its requirements for eligibility waiting periods to the federal standard adopted in the Affordable Care Act (ACA). Effective...more

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