Healthcare Patient Protection and Affordable Care Act (PPACA)

News & Analysis as of

Health Law Pulse - January 2016

CHANGES TO STARK LAW, NEW ADVANCE CARE PAYMENTS INCLUDED IN 2016 PHYSICIAN FEE SCHEDULE - The Centers for Medicare & Medicaid Services (CMS) recently published a final rule (Final Rule) regarding physician payment...more

Deadlines Extended on Cadillac Tax and ACA Forms 1095 and 1094 Reporting

In a recent Omnibus appropriations package, Congress extended the effective date for the Affordable Care Act (ACA) "Cadillac Tax" by two years, from plan years beginning on or after January 1, 2018, to plan years beginning on...more

The Managed Care Industry – 2015 Year in Review

As we start a new year, let’s take a look back at a few hot topics that emerged in the managed care industry in 2015 and will likely be drivers of developments in 2016. Industry Consolidation – The Changing Landscape...more

IRS Extends 2015 Affordable Care Act Information Reporting Deadlines

In a welcome development for employers and health coverage providers, the IRS has extended the Affordable Care Act information reporting deadlines. Unlike the prior transition relief in which the IRS delayed the information...more

Employee Benefits Developments - December 2015

ALERT: IRS Extends ACA Reporting Deadlines. With only a few days remaining in 2015, the IRS provided some welcome relief for employers subject to certain Affordable Care Act reporting requirements. Under IRS Notice 2016-4,...more

Happy New Year from the IRS

Yet another end-of-year brings another late-breaking IRS notice. The IRS has extended the deadlines that apply to employers and coverage providers for reporting health coverage through the 2015 Forms 1094/1095. ...more

ACA Outlook: What Will 2016 Hold for the Affordable Care Act and Employers?

For many employers, 2016 will bring new requirements and challenges with respect to compliance with the Affordable Care Act (ACA).  However, their burden in years beyond 2016 may very likely diminish because of recent changes...more

IRS Announces Affordable Care Act Reporting Extensions: McGuireWoods Healthcare Reform Guide: Installment No. 55

This is the 55th 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

Happy Holidays from the IRS: Deadlines Extended for Affordable Care Act Reporting Forms

This week, the IRS extended the due dates for providing ACA reporting forms to employees and filing the forms with the IRS. The extension applies to the forms for 2015, which are due in 2016....more

Further Guidance on ACA Market Reforms

Following up on the issuance of final regulations on various market reform provisions under the Affordable Care Act (ACA), the IRS has issued a notice with Questions and Answers that take a more detailed look at specific ACA...more

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

HealthCare.gov enrolls 8.2 million; Manatt and RWJF release an open access dataset on Marketplace plans nationwide; Montana names administrator for its Medicaid expansion; and Michigan gets the green light in the nick of time...more

Implementation of ACA’s Controversial “Cadillac Tax” Delayed Until 2020

Among the many requirements imposed by the Affordable Care Act, none are more controversial than the excise tax to be imposed on expensive health plans. This provision of the law, commonly known as the “Cadillac Tax,” would...more

Washington Healthcare Update

This Week: Congress raced to exit for the holidays and passed a $1.5 trillion omnibus spending bill and $680 billion tax-extenders package on Friday. The omnibus funds the government through September 2016. President Obama...more

National Association of Insurance Commissioners Updates Model Network Adequacy Law to Address Narrow Networks and Surprise Bills

On November 22, 2015, the National Association of Insurance Commissioners (“NAIC”) approved an updated version of its Managed Care Plan Network Adequacy Model Act, now known as the Health Benefit Plan Network Access and...more

CMS: U.S. Healthcare Spending Reaches $3 Trillion

Overall U.S. healthcare spending increased 5.3% in 2014 to reach $3.0 trillion, according to a report from CMS’ Office of the Actuary. The study indicated the growth experienced in 2014 was primarily attributable to...more

M&A Transactions: Affordable Care Act Due Diligence Considerations

The Affordable Care Act (ACA) has significantly changed the legal landscape for employer-sponsored health plans by adding reporting obligations, benefit mandates, fees, notices and potential penalties for plans that do not...more

FAQs Regarding the ACA’s Employer Reporting Requirements

The following blog post is Part 1 of a 2 part series exploring frequently asked questions regarding the Affordable Care Act’s Employer Reporting Requirements. Part 2 will focus on frequently asked questions related to Form...more

A&B Healthcare Week in Review, November 2015

I. REGULATIONS, NOTICES, & GUIDANCE - On November 21, 2015, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule entitled “Patient Protection and Affordable Care Act; HHS Notice of Benefit and...more

DOJ Antitrust Head Remains Focused on Health Care in Era of Consolidation

Speaking at an industry conference on November 13, U.S. Assistant Attorney General Bill Baer reiterated the government’s focus on competition concerns in the health care industry. According to Baer, head of the Department of...more

Washington Healthcare Update

This Week: Repealing Obamacare becomes problematic in the Senate... More focus on drug prices and reimbursement... FDA asks, should we regulate “natural” and if so, how? ...more

Washington Healthcare Update

This Week: Rep. Brady (R-TX) Named Chairman of the House Ways and Means Committee... Co-op Closures Subject of Two Hearings and More Letters... Drug Prices Subject of Investigations in Senate, House Dems Launch Task Force on...more

New Rule Permits Hospitals to Subsidize Physician Employees

A new 2016 Medicare physician payment rule allows hospitals and other provider institutions to make payments to physicians for the purpose of enabling them to employ nonphysician practitioners, such as nurse practitioners and...more

Hello Budget Agreement; Goodbye Provider-Based Status?

H.R. 1314, the Bipartisan Budget Act of 2015, was signed into law by President Obama on November 2, 2015. The two-year budget framework, which raises the federal debt limit through March 2017, partially rolls back the Budget...more

Budget Legislation Repeals Affordable Care Act’s Automatic Enrollment Requirement for Large Employers

The Bipartisan Budget Act of 2015, Pub. L. No. 114-74, which was signed by President Obama on November 2, 2015, included a little-publicized provision that repealed the Affordable Care Act’s automatic enrollment requirement. ...more

Identifying Overpayments Under the ACA’s 60-Day Rule Creates Additional Uncertainty in Determining False Claims Act Liability

Under the Affordable Care Act (ACA), healthcare providers that receive an overpayment from Medicare or Medicaid are required to report and return the overpayment to the government within 60 days after the date on which the...more

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