Healthcare Reform

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Manatt on Health Reform: Weekly Highlights: November 2014 #3

With the 2015 Open Enrollment Period (OEP) officially launched as of November 15, this week’s news highlights Marketplaces’ preparation for and tracking of outreach and enrollment – including 100,000 applications submitted on...more

Health Care Reform Implementation Update

Over the past several days, the second open enrollment period through the Affordable Care Act’s (ACA’s) health insurance exchanges began; Republican lawmakers, now with majorities in both the House and the Senate, explored...more

Supreme Court Will Hear Case on ACA Health Insurance Tax Credits

On Nov. 7, 2014, the U.S. Supreme Court announced that it will hear the case of King v. Burwell, one of multiple challenges to the validity of the premium tax credits provided under the Affordable Care Act (ACA) to...more

Why Providers Should Think About the Impact of ICD-10 on Managed Care Reimbursement Now

ICD-10 implementation has been delayed by Medicare until October 2015. Many believe it may be delayed again and are putting off thinking about its impact until it is clear that the updated code set will be implemented by...more

Agencies Come Down Hard on Various Employer Health Plans and Arrangements

As we move into 2015, employers continue to grapple with numerous Health Care Reform concepts. Employers should be cautious regarding arrangements promoted to avoid health care penalties because the agencies are cracking...more

Impact of Midterm Elections on Health Care

The November 4 elections saw the Republican party win control of the U.S. Senate, increase its majority in the House of Representatives, and increase its majority of governorships....more

SCOTUS to Review Subsidy Issue

On November 7, the U.S. Supreme Court announced it was going to review King v. Burwell. At issue in the case is whether Fourth Circuit correctly determined that the IRS did not exceed its authority when it released a rule in...more

U.S. Supreme Court Takes Up Major Challenge to Federal Health Reform

Are Employers in the 34 States Without Exchanges Subject to Penalties? - Despite the fact that there is no longer any disagreement in the lower courts, the Supreme Court on Friday, November 7, 2014, made the unusual...more

Post-Election Washington Outlook

In this issue: - Post-Election Analysis, the Lame Duck, and 114th Congress - Senate Election Results at a Glance - House Election Results at a Glance - Lame-Duck Session Outlook - Issues...more

The Affordable Care Act – Where Are We Now?

The ACA was signed into law in March of 2010 with the goals of increasing the quality and affordability of health insurance, lowering the uninsured rate by expanding public and private insurance coverage, and reducing the...more

Rules for CME, Revises List of Data Elements to be Reported

Last Friday, the Centers for Medicare & Medicaid Services (CMS) published a final rule with comment period addressing, among other issues, changes to the reporting and data collection requirements imposed upon “applicable...more

In-Patient Hospitalization and "Minimum Value" Under the ACA - Regulators Issue Guidance to Fix Minimum Value Calculator

The Patient Protection and Affordable Care Act – more commonly known as the Affordable Care Act (ACA) – imposes many requirements on group health plans, including, among others, that plans must provide "minimum value" (MV) in...more

CMS Releases CY 2015 Outpatient PPS/Ambulatory Surgical Center Final Rule

On October 31, 2014, CMS issued its CY 2015 outpatient and ambulatory surgical center (ASC) PPS final rule. CMS finalized a net payment rate increase of 2.2 percent under the OPPS. This figure includes a 2.9 percent market...more

CME Payments Exposed to Sunshine, But Not Too Much

Sometimes there’s less to life than meets the eye. Take the final rule issued last Friday by CMS on reporting CME (for continuing medical education) payments under the Physician Payments Sunshine Act....more

Health Care Update - November 2014

In This Issue: - CMS Releases Final Medicare Payment Rules - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional Initiatives - Other Health...more

Key Takeaways from OIG’s 2015 Work Plan

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Fiscal Year 2015 Work Plan on October 31. The Work Plan provides the OIG’s planned reviews and activities with respect to...more

Polsinelli Podcast - Republicans Gain Control of the U.S. Senate - How That May Impact Health Reform [Video]

Republicans gained control of the U.S. Senate winning seats in Arkansas, Colorado, Iowa, Montana, North Carolina, South Dakota and West Virginia. This is the first time since 2007 the Senate has gained majority control. How...more

DELAYED! HPID Deadline Is No Longer November 5

This past weekend the U.S. Department of Health and Human Services (HHS) indefinitely delayed enforcement of the requirement that all self-insured health plans obtain a Health Plan Identifier number (HPID). ...more

Indefinite Delay of Health Plan Identifier Rules

On Halloween, the Department of Health and Human Services announced an indefinite delay in enforcement of the health plan identifier (HPID) rules. As a result, large health plans are no longer required to choose whether to...more

Class Action Claims: Gluing Together Systemwide Judicial Relief

The award of class action certification is often the gateway for obtaining lifesaving systemwide judicial relief in broken correctional health care systems. It also can be the beginning of a decades-long, burdensome and...more

Health Care Reform Implementation Update

The Centers for Medicare and Medicaid Services (CMS) began sending reminders last week that open enrollment begins on November 15; CMS’s Marketplace CEO, Kevin Counihan, said that end-to-end testing of HealthCare.gov was...more

Private Equity Summary Report 2014

In This Issue: 1. Key Findings 2. Disruptive Forces 3. Health Care Private Equity Overview 4. Transaction Value 5. Subsector Activity 6. Venture Capital 7. Accountable Care Organizations 8....more

CMS Reopens the Medicare Payment Adjustment Hardship Exception Application Submission Period for Certain Providers and Hospitals

Centers for Medicare & Medicaid Services (CMS) recently announced the reopening of the submission period for hardship exception applications for eligible professionals and eligible hospitals that have been unable to fully...more

Manatt on Health Reform: Weekly Highlights: October 2014

This week, states’ Marketplaces are busy preparing for the 2015 Open Enrollment Period. Marketplaces are reviewing projected enrollment and renewal figures and releasing searchable databases for 2015 health plan rates, among...more

Health Law Pulse - October 2014

In This Issue: - CMS Updates Guidance on Hospital Governing Body and Medical Staff Conditions of Participation (CoPs) - DOL Announces Delay of Home Care Minimum Wage Enforcement - OIG Releases Special...more

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