News & Analysis as of

Reimbursements Patient Protection and Affordable Care Act (PPACA)

Health Insurance for U.S. Employees - A New Option for an Old Problem

by Hodgson Russ LLP on

There is good news in the world of U.S. health insurance laws, at least for Canadian companies with fewer than 50 full-time U.S. employees. Effective this year, it is now possible to directly reimburse employees for the cost...more

Court Instructs Federal Agencies to Re-Examine Their Response to Comments Regarding Out-of-Network Emergency Services...

by King & Spalding on

On August 31, 2017, the U.S. District Court for the District of Columbia held that HHS, the Department of Labor and the Department of Treasury (the Departments) failed to adequately address commenters’ concerns and proposed...more

Updated Health Care Reform Legislation Comparison Chart

The chart below compares key provisions of the Affordable Care Act (ACA), the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA). This chart is current as of July 13, 2017, and as of that date,...more

Value-based health care: fraud & abuse laws

by Ropes & Gray LLP on

Michael Lampert, Ropes & Gray health care partner, discusses fraud and abuse law application to value-based health care arrangements. __ Much has been made about how the fraud and abuse laws, which were designed in order...more

Proving Utility, Demonstrating Value: How to Align the Moving Parts in Personalized Medicine Reimbursement

by Foley & Lardner LLP on

Of the many business, operational, legal, regulatory and clinical obstacles standing in the way of widespread delivery of personalized medicine, the single greatest challenge may lie in solving the reimbursement puzzle....more

New Initiatives for the New Year: Highlights of the OIG’s 2017 Work Plan

by Alston & Bird on

On November 10, 2016, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its 2017 Work Plan. The 2017 Work Plan outlines the areas of special concern to the OIG and...more

New Law Allows Small Employers To Establish Stand-Alone Health Reimbursement Accounts

by Locke Lord LLP on

President Obama recently signed the 21st Century Cures Act (the Cures Act) which contains numerous health-care related provisions. One such provision allows small employers, beginning on and after January 1, 2017, to...more

Some Small Employers May Reimburse Employees' Premium and Other Uninsured Medical Expenses

by Clark Hill PLC on

The IRS previously determined that employers are not allowed to reimburse employees for premium expenses incurred for an individual health insurance policy or directly pay such premiums without violating the Patient...more

Are You Still Reimbursing Premiums For Your Employee's Individual Healthcare Insurance? Then You'd Better Read This!!

by Tucker Arensberg, P.C. on

In the past, many employers (especially smaller companies) have offered to pay their employees’ premiums for individual healthcare insurance instead of sponsoring their own group health plans. With the advent of the...more

Court Finds Faulty Funding Provisions in Affordable Care Act Affect Low-Income Affordability Provisions

On Thursday, May 12, 2016, a federal district court judge ruled against the Obama administration, finding that no appropriations have been made to fund payments under Section 1402 of the Affordable Care Act to reimburse...more

Judge rules HHS can't pay cost-sharing subsidies to QHPs, but allows funding to continue

by Dentons on

More than six years after the Affordable Care Act (ACA) was enacted, legal challenges continue to thread their way through the judicial system. In a May 12, 2016 decision, US District Court Judge Rosemary M. Collyer, an...more

House Republicans Win Challenge to ACA Cost-Sharing Subsidies

by King & Spalding on

On May 12, 2016, the U.S. District Court in Washington, D.C. ruled in favor of House Republicans, concluding that the government wrongly spent billions reimbursing insurance companies for providing discounted health coverage...more

House of Representatives v. Burwell: Another Blow to Obamacare

by Foley & Lardner LLP on

Federal Judge Rosemary Collyer’s May 12, 2016 ruling in House of Representatives v. Burwell, found that the Obama administration (the “Administration”) has been improperly funding an Obamacare subsidy program. House of...more

District Court Rules One Aspect of ACA is Unconstitutional—No Change for Employers

by Winstead PC on

You may have heard that a federal District Court ruled that the ACA was unconstitutional today. Do not start making any changes. This decision will not directly impact most employers and their health plans. We are sending...more

A District Court Just Dealt a Blow to the ACA. Employers, Don’t Get Excited!

by Jackson Lewis P.C. on

On May 12, 2016, the United States District Court for the District of Columbia issued an opinion in U.S. House of Representatives v. Burwell et al., No. 14-1967 (D.D.C. May 12, 2016), enjoining the federal government’s use of...more

The ERISA Litigation Newsletter - March 2016

by Proskauer Rose LLP on

Editor’s Overview - This month we review the U.S. Supreme Court’s decision in Montanile v. Board of Trustees of National Elevator Industries Health Benefit Plan where the Supreme Court considered the scope of...more

Partnering with nonprovider sites: Tips to keep in mind

by Dentons on

Provided applicable requirements are met, the Medicare program reimburses teaching hospitals for resident training that occurs both at the hospital itself and at clinical nonprovider locations, including, for example,...more

Reporting for ACA Mandates: Final Forms and Additional Guidance

by Ballard Spahr LLP on

The IRS has finalized the 2015 forms and instructions for reporting under the individual and employer mandates and issued additional guidance on these new reporting requirements. The following forms are now available...more

The ERISA Litigation Newsletter - August 2015

by Proskauer Rose LLP on

Editor's Overview - As the summer draws to a close, this month's Newsletter previews three cases that the U.S. Supreme Court already has agreed to hear that ought to be of particular interest to ERISA plan sponsors and...more

Short-Term Relief for Small Employers Reimbursing Employee Premiums - But Significant Penalties Loom if You Don’t Stop Soon!

by Poyner Spruill LLP on

For nearly two years now, the IRS has been explaining that employers are no longer permitted to reimburse employees for premiums the employees paid for individual health insurance coverage....more

Medical Insurance Premium Reimbursement — A Brief Reprieve for Small Employers

Some employers – particularly smaller ones – have assisted their employees to obtain health insurance by reimbursing them for the cost of insurance they purchase in the individual market. Does this practice satisfy the...more

Manatt on Health Reform: Weekly Highlights #4

This week, the IRS announces relief for some taxpayers who received excess advanced premium tax credits; Indiana and Arkansas make major announcements on Medicaid expansion and Iowa’s Governor announces a shift towards...more

Caution: Big Penalties for Reimbursing Health Care Premiums

by LeClairRyan on

Even if you are a small employer who is not required to provide your employees with health insurance under the Affordable Care Act (ACA), if you reimburse your employees for health insurance premiums, you run the risk of...more

Want to Reimburse Your Employees for Healthcare Coverage?

by Ervin Cohen & Jessup LLP on

Fine, but make sure that you do so correctly. Many employers prefer to reimburse employees for healthcare insurance premiums rather than hassle with providing coverage under a group healthcare plan. In so doing, these...more

Employer Cash Payments To Reimburse Employees For Health Insurance Costs – No!

by Charles (Chuck) Rubin on

Many employers offer or provide cash to employees to reimburse them for the cost of purchasing an individual health insurance policy. Others offer employees with high claims risk a choice between enrolling in the company’s...more

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