Affordable Care Act, Co-Op

Health Care Providers with Claims Arising Out of New York’s Failed Health Republic Insurance Co. to Be Paid in Full

Epstein Becker & Green on 5/19/2021

In December 2015, we wrote about the many failed health insurance co-ops created under the Affordable Care Act (“ACA”), and the impact of those failures on providers and other creditors, consumers, and taxpayers. At that...more

Did the Tenth Circuit Just Put the Final Nail in the Coffin for Challenges to the Use of “Statewide Average Premium” in Risk...

Mintz - Health Care Viewpoints on 1/9/2020

On December 31, 2019, the Tenth Circuit Court of Appeals upheld the Department of Health & Human Services’ Affordable Care Act (ACA) risk adjustment methodology in New Mexico Health Connections v. HHS, No. 18-2186 (10th Cir....more

New Mexico Court Affirms Ruling in ACA Risk Corridor Case

Mintz - Health Care Viewpoints on 11/7/2018

On October 19, 2018, a New Mexico district judge rejected a request from HHS to reconsider a February decision that had briefly led to the suspension of the ACA’s risk adjustment program. In February, District Judge James...more

CMS, In a Reversal, Announces Plans to Continue Funding Risk Adjustment Payments

Mintz - Health Care Viewpoints on 8/10/2018

On Wednesday, August 8, CMS filed a proposed rule clearing the way for the federal government to continue making payments under the ACA’s risk adjustment program for the benefit year 2018. The 2018 proposed rule is...more

Manatt on Health Reform: Weekly Highlights - April 2017 #4

Manatt, Phelps & Phillips, LLP on 4/26/2017

The ACA reduced uninsurance among veterans by 40%; Marketplaces showed signs of stabilizing in 2016; and some states are giving insurers more time to make decisions about offering coverage on the Marketplace next year in...more

Manatt on Health Reform: Weekly Highlights - October 2016

Manatt, Phelps & Phillips, LLP on 10/5/2016

Vermont moves closer to launching the country’s first all-payer ACO; CMS approves Arizona’s 1115 waiver extension but rejects the State’s proposed work requirement and premiums for those earning below the FPL; and CMS issues...more

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

Manatt, Phelps & Phillips, LLP on 8/10/2016

CMS targets Medicaid managed care pass-through payments; California proposes “California Qualified Health Plans” for the undocumented; and a new study finds out-of-pocket costs were reduced by nearly a third for Medicaid...more

Manatt on Health Reform: Weekly Highlights - July 2016 #4

Manatt, Phelps & Phillips, LLP on 7/27/2016

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

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

Manatt, Phelps & Phillips, LLP on 7/14/2016

The President voices support for a public option; Vermont selects a Medicaid ACO; and Alabama ends enhanced primary care reimbursements....more

New Amendments Grant Failing ACA Co-Op Program Access to Private Capital and Limit Special Enrollment Eligibility

Sheppard Mullin Richter & Hampton LLP on 5/18/2016

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) passed an interim final rule that amends regulations governing Consumer Operated and Oriented Plans (Co-ops) and tightens restrictions on special...more

The Impact of Health Insurance Co-Op Liquidations on Providers

Epstein Becker & Green on 12/7/2015

A growing number of health insurance co-ops or “consumer operated and oriented plans” created under the Affordable Care Act (“ACA”) are shutting down on their own initiative or on orders of state regulators because of their...more

Manatt on Health Reform: Weekly Highlights - November 2015 #2

Manatt, Phelps & Phillips, LLP on 11/11/2015

With the election of a new Governor, the future of Kentucky’s Marketplace and Medicaid expansion is uncertain; CMS questions Iowa on its Medicaid managed care transition timeline; and the Supreme Court agrees to hear a case...more

Manatt on Health Reform: Weekly Highlights - November 2015

Manatt, Phelps & Phillips, LLP on 11/5/2015

Montana receives approval to expand Medicaid beginning 2016; California’s $6.2 billion Medicaid waiver receives pre-approval; and HHS proposes broadening circumstances under which states receive enhanced federal matching...more

Health Care Update - November 2015

Mintz - ML Strategies on 11/4/2015

Ways & Means Leadership Changes – Health Policy Implications Looming: As Congress pushes forward with a two-year budget deal, and new Speaker Paul Ryan begins his tenure as the top Republican in the House of...more

Health Care Update - October 2015

Mintz - ML Strategies on 10/29/2015

Senate Working Group Pressing Forward on Telehealth - As Congress focuses on bigger picture policy decisions, including broad budget negotiations and raising the debt ceiling, there are some exciting developments on the...more

Manatt on Health Reform: Weekly Highlights - October 2015 #3

Manatt, Phelps & Phillips, LLP on 10/21/2015

Arizona seeks Medicaid Waiver to implement new coverage restrictions for Medicaid expansion enrollees and delivery system reform; Tennessee’s uninsured rate continues to drop; and Louisiana gubernatorial candidates line up...more

Health Care Update - October 2015

Mintz - ML Strategies on 10/20/2015

Cuts in Mandatory Entitlement Programs Center of Budget Negotiations: As budget negotiators from both sides of the Hill come together to work out a two-year budget deal, determining how sequestration relief will be paid for...more

Manatt on Health Reform: Weekly Highlights - September 2015 #5

Manatt, Phelps & Phillips, LLP on 9/30/2015

New study shows Marketplace premiums parallel the employer market; Montana likely to select a private insurer to administer benefits to its Medicaid expansion population; and Washington’s Exchange customers will begin paying...more

Manatt on Health Reform: Weekly Highlights - September 2015

Manatt, Phelps & Phillips, LLP on 9/4/2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

Under the Dome: Inside the Maine State House

Pierce Atwood LLP on 8/7/2015

Under the Dome: Inside the Maine State House provides a high-level overview of recent activity at the Maine State House. A Unanimous Decision - A sequence of events led to the creation of 65 controversial vetoes...more

Iowa Insurance Commissioner Petitions for Liquidation of Iowa/Nebraska CO-OP; How Financially Sound Are Others?

Foley & Lardner LLP on 2/4/2015

The Iowa Commissioner of Insurance (the “Commissioner”) filed a petition, on January 29, 2015, seeking to liquidate CoOpportunity Health, Inc. (“CoOpportunity”), a Consumer Operated and Oriented Plan (“CO-OP”) established...more

Healthcare Provisions In The American Taxpayer Relief Act - The Good, The Bad And The Ugly

BakerHostetler on 1/15/2013

In late night action on December 31, 2012, the American Taxpayer Relief Act of 2012 (ATRA) was passed by the Senate and finalized days later by Congress and the President with a set of tax and spending policy provisions...more

Health Care Reform Implementation Update - January 14, 2013

Cozen O'Connor on 1/14/2013

The Obama administration gave eight more states conditional approval to operate health insurance exchanges, bringing the total number of fully or partially approved exchanges to 20; HHS approved 106 new accountable care...more

Fiscal Cliff Deal and Healthcare: 3-Point Bulletin

Cozen O'Connor on 1/11/2013

On January 1, President Obama signed the American Taxpayer Relief Act of 2012 into law to prevent the country from going over the proverbial “fiscal cliff.” The fiscal cliff deal prevents the scheduled 26.5% cut in...more

Patient Protection and Affordable Care Act (PPACA) › Co-Op

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