Patient Protection and Affordable Care Act (PPACA)

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
News & Analysis as of

Long-Awaited Medicaid Managed Care Guidance to be Published Monday

On June 1, 2015, the Centers for Medicare and Medicaid Services (CMS) will publish in the Federal Register a long-awaited proposed rule addressing Medicaid Managed Care Organizations (MMCOs). Comments on the proposed rule...more

Massive CMS rule seeks to align Medicaid managed care with Medicare Advantage and marketplace plans

Yesterday, the US Centers for Medicare & Medicaid Services (CMS) published its long anticipated proposed rule on Medicaid managed care. The ambitious proposal (CMS-2390-P) represents the first update to managed care...more

Five Employment, Labor, and Workforce Management Concerns Impacting Retailers

Retailers will be busy this summer attempting to conform their policies and procedures to various local, state, and federal laws, such as the spate of state and city sick leave laws, and analyzing proposed amendments by the...more

OSHA Issues Revised Whistleblower Investigations Manual

Continuing its emphasis on its Whistleblower Protection Program, the Occupational Safety and Health Administration (OSHA) released an updated Whistleblower Investigations Manual on May 21, 2015. OSHA enforces whistleblower...more

Late to the Party: EEOC Proposes Wellness Program Regulations McGuireWoods Healthcare Reform Guide: Installment No. 50

This is the 50th 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

HHS Solicits Comments on Use of Health Plan Identifier in E-Health Transactions

Today HHS published a request for public comments regarding the health plan identifier (HPID), including the requirements regarding health plan enumeration, and the requirement to use the HPID in electronic health care...more

New Guidance on Cost-Sharing Limits and Provider Nondiscrimination Rules

The U.S. Departments of Labor, Health and Human Services, and the Treasury have jointly issued a new set of FAQs that clarifies the application of the rules establishing cost-sharing limits. For 2016, non-grandfathered group...more

Washington Healthcare Update

This Week: House E&C 21st Century Cures Bill Passes Unanimously Out of Committee... House Votes to Codify Permanent R&D Tax Credit... CMS Released Proposed Rule Concerning Medicaid and CHIP Plans....more

The Medicaid Fraud Control Units: Fiscal Year 2014 Report

The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2014 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCUs)...more

Employer Paid Individual Health Insurance Policies Create the Potential for Significant Penalties, But Limited Relief Is Available

Despite guidance from the Internal Revenue Service (“IRS”), the Department of Labor (“DOL”) and the Department of Health and Human Services (“HHS”) indicating the prohibition of the practice under the Affordable Care Act...more

Health Care Update - May 2015 #4

In This Issue: - House Energy and Commerce Unanimously Advances 21st Century Cures Legislation - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional...more

CMS Proposes Major Update to Medicaid Managed Care Regulations

The Centers for Medicare and Medicaid Services (“CMS”) released, on May 26, 2015, the a far-ranging proposal for revising the Medicaid managed care regulations (“Proposed Rule”). The number of individuals enrolled in Medicaid...more

Coverage Options for Massachusetts: Leveraging the Affordable Care Act

Massachusetts led the nation in expanding healthcare coverage and reforming its payment and delivery models, with considerable success. The Affordable Care Act (ACA) provided Massachusetts with new tools and new funding,...more

HHS Revises, Delays Medicare Enrollment Requirements for Part D Prescriptions

The Affordable Care Act authorized the Department of Health and Human Services (HHS) to require a physician, dentist or other healthcare provider to be enrolled in the Medicare program before they can issue a prescription...more

An Update on 21st Century Cures Legislation

Last week the Personalized Medicine Coalition held its 11th Annual State of Personalized Medicine luncheon in Washington, D.C. U.S. Representative Michael Burgess, a member of the House Energy and Commerce Committee...more

IRS Issues Q&As on Information Reporting under Code Section 6055 and 6056

Thursday, the U.S. Internal Revenue Service issued new Questions & Answers regarding the Affordable Care Act’s reporting rules under Code Section 6055 and 6056. The categories under the guidance include: Basics of the...more

Physicians as whistleblowers: Doctors get rich by exposing fraud

As the federal and state governments have evolved from Uncle Sam to Doctor Sam, the potential for healthcare waste, fraud and abuse has also increased. One way the government has deterred healthcare fraud is by enacting and...more

Bill Introduced to Repeal Cadillac Tax

A bill has been introduced in the House of Representatives that would repeal the “Cadillac Tax” provision of the Affordable Care Act (codified in Internal Revenue Code Section 4980I). The Cadillac Tax provision imposes an...more

Spring Regulatory Agenda Sets Forth New Deadlines, Proposals

In keeping with past practice, federal agencies released their spring regulatory agendas on the eve of a holiday weekend. These semiannual reports list all of the federal agency regulations currently under development or...more

Shaking Down the Thunder From the Sky: Part 2 of Notre Dame's Challenge to the Contraception Mandate

For the second time in as many years, the Seventh Circuit has declined to grant Notre Dame’s request for an injunction exempting the university from the contraception requirements of the Affordable Care Act. As was true back...more

OIG Early Alert on State-Based ACA Marketplace Funding Use

The OIG has issued an “Early Alert” warning regarding the use of federal funding by state-based marketplaces under the Affordable Care Act (ACA). The OIG notes that the ACA clearly prohibits marketplaces from using grant...more

Anatomy of a Provider-Merger Antitrust Challenge (Part 6)

This is the concluding installment of a six-part series discussing the Federal Trade Commission's challenges to provider mergers. Following the initial Introduction and Background (Part 1), the series discusses The Need for...more

The ERISA Litigation Newsletter - May 2015

Editor's Overview - This month we focus on the EEOC's proposed rules concerning wellness programs. As our colleague, Amy Covert, discusses, a recent change of position by the EEOC provides employers with opportunities...more

Religious Institutions Update: May 2015

Religious institutions commonly keep ministry supporters and members abreast of developments through newsletters, correspondence and other communications. Sometimes, the developments reported are embarrassing to those...more

Health Care Update - May 2015 #3

In This Issue: - 21st Century Cures Markup; Full Committee to Take Up this Week - Senate Finance Committee Solicits Health Bills for Upcoming Markup - Implementation of the Affordable Care Act - Federal...more

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