News & Analysis as of September 21, 2024

Payment Plans

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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 Affordable Care Act—Countdown to Compliance for Employers, Week 30: The IRS Tells Us that Employer Payment Plans (Really,...

Mintz - Employment, Labor & Benefits... on 6/3/2014

The IRS recently issued two Q&As on the subject of employer payment plans, the purpose of which was to again underscore that arrangements purporting to allow an employer to reimburse employees on a pre-tax basis for premiums...more

New Guidance Clarifies Health Reimbursement Arrangements Under ACA

McDermott Will & Emery on 10/24/2013

Recently issued guidance clarifies the application of certain provisions under the Affordable Care Act (ACA) to health reimbursement arrangements, employer payment plans, health flexible spending arrangements and employee...more

Guidance on the Application of Certain ACA Market Reforms to Employer Health Plans

Morgan Lewis on 10/21/2013

Plan sponsors should review their health reimbursement arrangements, employer payment plans, health flexible spending arrangements, and employee assistance programs to ensure they comply with ACA market reforms....more

CMS Proposes FQHC Prospective Payment System

Baker Donelson on 10/18/2013

On September 23, 2013, CMS published a proposed rule to overhaul the payment methodology for federally qualified health centers (FQHCs). The proposed rule will change FQHC reimbursement from an all inclusive rate (AIR),...more

CMS Releases FY 2014 Hospital IPPS Final Rule

King & Spalding on 8/6/2013

On August 2, 2013, CMS released the annual Hospital Inpatient Prospective Payment System Final Rule for FY 2014 (the “Final Rule”), effective for discharges occurring on or after October 1, 2013....more

CMS Proposes FY 2014 Payment Rates and Policies for Medicare Inpatient Rehabilitation Facilities

Baker Donelson on 5/31/2013

On May 2, 2013, CMS released a proposed rule [PDF] for the Inpatient Rehabilitation Facility Prospective Payment System for fiscal year (FY) 2014. The proposed rule sets forth Medicare payment policies and rates governing...more

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

BakerHostetler on 5/17/2013

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

OIG Revises Special Advisory Bulletin on Exclusions

Morgan Lewis on 5/10/2013

OIG continues its aggressive interpretation of scope and effect of exclusion from participation in Federal health care programs and clarifies several open questions....more

The New DSH - Are You Supplying The Correct Data That Will Drive Your Payments?

Baker Donelson on 4/8/2013

Effective October 1, 2013, CMS will begin paying disproportionate share hospitals differently. Congress ordered the change to the disproportionate share hospital (DSH) adjustment payment methodology as part of the Patient...more

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