News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) Medicare

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 -

DOJ Settles Second 60-Day Overpayment Case, Highlights Broader Reach of the FCA’s Reverse False Claims Provision

by Reed Smith on

A recent False Claims Act (“FCA”) settlement involving an allegedly overpaid Florida medical practice reaffirms the interplay between the 60-Day Overpayment Statute and the FCA, but also highlights the importance for all...more

Capitol Hill Healthcare Update

by BakerHostetler on

The House last week voted to renew the Children’s Health Insurance Program (CHIP) through 2022, but disagreements over how to pay for the program are likely to delay consideration in the Senate beyond this month. On a...more

On-Site Clinics: What Effect On HDHPs And HSAs?

by Jackson Lewis P.C. on

As of October 2017, Health Care Still Uncertain. We already know the state of health care in the United States continues to whipsaw, as an October 25th ruling demonstrates: a federal district court confirmed that the Trump...more

The Teaching Health Center Graduate Medical Education Program: Overview, updates and future considerations

by Dentons on

The Patient Protection and Affordable Care Act of 2010 (ACA) established the Teaching Health Center Graduate Medical Education (THCGME) program to expand training in community-based primary care settings, particularly in...more

Will the Massachusetts Proposed Legislation on Hospital Outpatient Facility Fees Have a Nationwide Impact?

by Foley & Lardner LLP on

In some states, including the Commonwealth of Massachusetts, “site neutrality” for outpatient hospital reimbursement is factoring into state-specific health reform and cost containment initiatives. This potentially goes...more

Capitol Hill Healthcare Update

by BakerHostetler on

House Majority Leader Kevin McCarthy (R-Calif.) said lawmakers will vote this week on legislation to renew federal funding for the Children’s Health Insurance Program (CHIP), even amid unresolved partisan disagreements over...more

Ways & Means Committee Advances IPAB Repeal Bill

by Reed Smith on

The House Ways and Means Committee has approved by a 24-13 vote HR 849, Protecting Seniors’ Access to Medicare Act, to repeal the Independent Payment Advisory Board (IPAB). The IPAB was established by the ACA to submit...more

Special Needs Plans: A Minibus Rider

As Part of an ongoing series, we have previously provided details on the structure, funding, and evaluation of the Maternal, Infant, Early Childhood, Home Visiting (MIECHV) program, Medicare therapy caps, and community health...more

Capitol Hill Healthcare Update

by BakerHostetler on

President Donald Trump is considering appointing lawmakers to a bipartisan commission that would develop strategies to lower prescription drug prices, while senators last week called for greater transparency into how...more

Disproportionate Share Hospital Payments: A Minibus Rider

As a part of our ongoing blog series we have provided details on the structure, funding, and outlook of several expiring health care provisions, that we’ve referred to as the health care minibus. The minibus includes all of...more

CHIP Reauthorization Legislation and Medicare-Medicaid Extender Provisions

by Holland & Knight LLP on

In this memorandum, Holland & Knight's Healthcare & Life Sciences Team summarizes recent legislative action on funding for the Children's Health Insurance Program (CHIP). The Senate Finance Committee and the House Energy...more

Capitol Hill Healthcare Update

by BakerHostetler on

Although the Children’s Health Insurance Program (CHIP) enjoys broad bipartisan support on Capitol Hill, lawmakers last week sharply disagreed over how to pay for its renewal – signaling that a final vote could be delayed for...more

Focus on Health Care Provider Bankruptcies

by Jones Day on

The next few years are expected to see a significant increase in the volume of bankruptcy cases filed by health care providers. Thus far in 2017, the number of bankruptcies in health care-related sectors, including hospitals,...more

CMS Issues New Instructions for Completing Worksheet S-10 and Extends Deadline for Providers to Submit Updated Data for FYs 2014...

by King & Spalding on

For the second time in less than one year, CMS has updated its instructions for completing Worksheet S-10 of the Medicare cost report for hospitals. The new instructions expand the definition of charity care, as reported in...more

Lending Against Medicare/Medicaid Receivables: A Refresher Course

by Burns & Levinson LLP on

With the failed effort to overturn the Patient Protection and Affordable Care Act (a/k/a Obamacare) this week, the expansion of Medicaid coverage in effect since that law’s passage will be around for a while. The bill to...more

Disproportionate Share Hospitals Facing Steep Payment Cuts

While September 30, 2017 has been an important procedural deadline for purposes of the GOP’s most recent legislative push to repeal the Affordable Care Act (ACA), it also serves a critical funding deadline for purposes of the...more

CMS Seeks New Direction for Center for Medicare and Medicaid Innovation

by King & Spalding on

On September 20, 2017, the Center for Medicare and Medicaid Innovation (“CMMI”) issued an informal Request for Information (“RFI”) seeking public feedback on “a new direction to promote patient-centered care and test...more

Fractal Geometry, Actuarial Risk, and §1332 Waivers—The Role of the States in Reforming Health Care

At this writing, the prospects for success of the latest Republican effort to replace the Affordable Care Act appear bleak — but the Graham-Cassidy bill on which the GOP has pinned its last-ditch hopes highlights a major...more

Health Care Reform Returns to the Spotlight

by Foley & Lardner LLP on

Congress is now back in session and, once again, focus has turned to health care. With all eyes on returning health care reform to the forefront, a flurry of activity has sparked new legislative efforts including the...more

Window on Washington - This Week in the Nation's Capital - Vol. 1, Issue 26

by Clark Hill PLC on

House Finishes Work on Its Annual Appropriations Bills, For Now: The House narrowly passed a $1.2 trillion package of spending bills to fund the government for Fiscal Year 2018 by a vote of 211-198. Amendments offered to the...more

Manatt on Health: September 2017

1332 Waivers Under Review at CMS - The Trump administration has approved one 1332 waiver to date, but four more are pending, including a sweeping Iowa waiver. Here is where things stand today...more

Value-based health care: the role of payors

by Ropes & Gray LLP on

Bill Knowlton, Ropes & Gray health care partner, examines the critically important role of payors in value-based health care programs. ____________ Payors are critically important to value-based health care because they're...more

Reminder: Medical Providers Must Be Attentive to Credit Balances and Other Overpayments

It has now been a number of years since the enactment of Section 6402(a) of the Affordable Care Act ("ACA"), which requires among other things that any recipient of a Medicare or Medicaid overpayment report and return it...more

Telehealth Remains a Top Priority for Advancing Quality Health Care

by Faegre Baker Daniels on

Even with the prospect of Obamacare repeal and replace on the backburner for now, the federal government continues to focus on health care. Following August recess, Congress will have less than four weeks to work through...more

Trustees Predict Medicare Solvent Until 2029; IPAB Not Triggered Until 2021

by Baker Donelson on

On July 13, the Boards of Trustees for Medicare issued the annual Trustees Report to the Congress on the financial operations and actuarial status of the Medicare Program. The trustees estimate that the trust fund financing...more

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