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Manatt on Medicaid: A Closer Look at Wisconsin’s Premium Proposal

The State of Wisconsin recently proposed a Medicaid waiver that includes a number of precedent-setting features, including a 48-month time limit on enrollment (with the limit paused for periods of employment or job training),...more

Court Held That Settlor Had Standing To Assert Extra-Contractual Misrepresentation Claims Regarding Insurance Policies He...

by Winstead PC on

In Lee v. Rogers Agency, Lee purchased three whole-life insurance policies in the 1980s where each had a face value of $1,000,000. No. 06-15-00037, 2017 Tex. App. LEXIS 1069 (Tex. App.—Texarkana February 8, 2017, pet. filed)....more

Manatt on Medicaid: Maine Releases Draft Waiver Request Proposing New Eligibility Requirements

On April 25, 2017, the Maine Department of Health and Human Services released for public comment a draft Section 1115 waiver application to implement new eligibility and coverage requirements for MaineCare, the State’s...more

Stabilizing the Exchanges: CMS Issues Final Rule

by Bass, Berry & Sims PLC on

On April 18, 2017, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a final rule (the "Final Rule") aimed at stabilizing the individual and small group health insurance markets...more

House Amends the American Health Care Act: Where Will It Lead?

by Perkins Coie on

On the last day before the U.S. Congress began its spring recess, the U.S. House of Representatives amended the now consolidated bill H.R. 1628, known as the American Health Care Act (the AHCA). We previously discussed the...more

ACA Repeal and Replace Update: House Vote Expected This Week; CBO Estimates Impact of Repeal and Replace Legislation; CMS...

by King & Spalding on

After narrowly passing the Budget Committee, the Republican-sponsored health reform repeal and replace bill, the American Health Care Act (AHCA), is scheduled for a floor vote for Thursday, March 23, 2017, seven years to the...more

Health Update - March 2017

The Future of Essential Health Benefits - Editor's Note: The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and...more

Things to Remember at Tax Time

Tax day, which is April 18th in 2017, is approaching and it is time to begin crossing T's and dotting I's in preparation for paying taxes. As tax time draws near, you want to make sure you file all the proper forms and take...more

Illinois Supreme Court Holds Occupational Disease Pension Does Not Trigger Health Insurance Benefits

by Sedgwick LLP on

In 2003, the Illinois Supreme Court held that anyone who qualified for a line-of-duty pension under section 4-110 of the Illinois Pension Code qualified as having a “catastrophic injury” within the meaning of Section 10(a) of...more

Employee Benefits Developments - January 2017

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of January, 2017. Click through the links below for more information on each specific development or case. IRS...more

Court Affirms Dismissal Of Cedent’s Claims Asserting Reinsurance Premium Fraud Scheme, Based On Expiration Of Limitations Period

by Carlton Fields on

The appellant (Guarantee Trust) had forwarded reinsurance premiums to the reinsurer to be held in a custodial account for the payment of claims. Guarantee Trust initially sued Kribbs, the founder of the reinsurer, alleging...more

2016 Health Care Year in Review

by Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

What Trump’s HHS Secretary Appointment Could Mean for Healthcare Providers

by Nilan Johnson Lewis PA on

President-elect Donald Trump announced on November 28, 2016, that current House Budget Chair Representative Tom Price is his choice for Health and Human Services (HHS) Secretary. Many providers are wondering what health care...more

Manatt on Health Reform: Weekly Highlights - November 2016

Minnesota’s Governor and legislators propose financial assistance options for on- and off-Marketplace individual coverage; Vermont receives final federal approval for the country’s first all-payer ACO model; and a report...more

The 2016 Election and Your Healthcare System: What’s at Stake?

Regardless of the 2016 general election outcome, a new administration will have to respond to pressing policy issues that will shape continued transformation of the U.S. healthcare system. What are the issues and where do...more

Manatt on Health Reform: Weekly Highlights - October 2016 #3

HealthCare.gov consumers begin previewing 2017 coverage options as HHS projects a 9% enrollment increase over last year and an average 22% benchmark premium increase; Oregon study finds increased primary care spending in...more

NAIC Long-Term Care Innovation Subgroup Public Hearing

by Carlton Fields on

At the NAIC Summer 2016 National Meeting, the Long-Term Care Innovation (B) Subgroup held a public hearing as part of an initiative to address the challenges facing the private LTC market. With baby boomers retiring at a rate...more

Manatt on Health Reform: Weekly Highlights - October 2016 #2

Kentucky receives final approval from CMS to transition its Marketplace to the HealthCare.gov platform; Ohio puts a prescription drug price ceiling on its November 2017 ballot; and a new study links Medicaid expansion to...more

Manatt on Health Reform: Weekly Highlights - September 2016 #3

Study finds that Marketplace premiums are lower than employer-based premiums, even without federal subsidies; New York regulators move to shield insurers from outsized federal risk adjustment payments; and Missouri will seek...more

Put Me in Coach! Using Split Dollar Life Insurance Plans to Compensate Division I Coaches

by Gerald Nowotny on

In August 2016, the national sports media provided details regarding the compensation package for Coach Jim Harbaugh at the University of Michigan. It comes as no surprise to anyone that Division I football and basketball...more

Manatt on Health Reform: Weekly Highlights - August 2016 #5

A federal report finds that Marketplace premiums are lower in expansion states; Massachusetts and Pennsylvania launch prescription drug monitoring systems; and Kentucky submits a slightly modified Medicaid expansion waiver to...more

Appellate Division Finds c.78 Health Benefits Contributions Requirements Do Not Apply to Public Sector Disability Retirees

by Genova Burns LLC on

Last month, in Brick Twp. PBA Local 230 v. Twp. of Brick, the Appellate Division of the Superior Court of New Jersey confirmed that N.J.S.A. 40A:10-21.1, P.L. 2011, c. 78, § 42, more commonly known as Chapter 78, does not...more

Recent Congressional Hearings

by Reed Smith on

Congressional committees held hearings on a wide variety of on health policy issues this month before going on summer recess. Notable hearings include the following...more

Just How Is Basis Acquired After All?

by Bryan Cave on

Dorrance v. U.S., 2015 WL 8241954 (9th Cir. 2015) - This case is the latest in the cases involving tax impact of the sale of stock received by a policy holder from a mutual life insurance company on demutualization, and...more

UPDATE: Is Your Workers’ Compensation Program Unlawful?

Under a ruling this week from the California Insurance Commissioner, your company may be insured under an unenforceable workers’ compensation program. You may also be entitled to a refund of premiums paid to California...more

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