News & Analysis as of

Centers for Medicare & Medicaid Services Patient Protection and Affordable Care Act (PPACA)

Capitol Hill Healthcare Update

by BakerHostetler on

Lawmakers last week approved a stopgap budget bill to keep the government open until Dec. 22, creating a pre-Christmas showdown over a host of spending decisions and key healthcare priorities. Republican leaders on Capitol...more

Capitol Hill Healthcare Update

by BakerHostetler on

Congressional Republicans face a Friday deadline to approve a stopgap budget bill to avert a government shutdown, delaying until later this month key decisions on healthcare priorities like renewing children’s insurance and...more

Courts May Not Review CMS’s Determination to Grant or Deny a Hospital’s Expansion Application Under Stark

by King & Spalding on

In a decision issued on November 21, 2017, the D.C. Circuit affirmed the district court determination that the Affordable Care Act (ACA) bars judicial review of CMS’s determination to grant or deny a hospital’s Stark Law...more

Manatt on Health: Medicaid Edition: CMS Administrator Highlights Medicaid Policy Goals and New Guidance

Since assuming office last January, the Trump administration has signaled a shift in Medicaid policy. In early November, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma made the administration’s...more

Capitol Hill Healthcare Update

by BakerHostetler on

Lawmakers returning to Capitol Hill this week after the Thanksgiving recess face a daunting series of tax and budget deadlines that will set the stage for how Congress addresses year-end healthcare priorities. That...more

Health Update - November 2017

Fraud and Abuse 2017: Understanding Trends and Avoiding Actions - Editor’s Note: In a recent webinar for Bloomberg BNA, Manatt examined game-changing fraud and abuse trends and cases—and revealed strategies for avoiding...more

Health Care E-Note - November 2017

by Burr & Forman on

Health care law and policy occupy a prime place in the current news cycle. Much of the attention revolves around the actions or inactions of Congress and the White House, particularly with regard to their impact on the future...more

Hospitals & Physician Organizations Summary Report - November 2017

by Benesch on

Uncertainty and pressures continue to mount for healthcare providers, creating a new operating environment – Uncertainty around Medicaid and other programs, the shift to value-based care, margin pressures, the need to search...more

CHIP Reauthorization Stalls in Congress, Increasing Fiscal Pressure on States

by Baker Donelson on

Reauthorization of federal funding for the Children's Health Insurance Program (CHIP) has stalled in Congress due to partisan disagreements over fiscal offsets. The delay in the extension of federal funding has put...more

Affordable Care Act Initially Fades from Spotlight; Reemerges in Senate Republicans' Latest Tax Proposal

by Baker Donelson on

After dominating the agenda for most of 2017, the Affordable Care Act (ACA) seemed to take a backseat at first as Republicans shifted their focus to enacting tax legislation. The initial momentum behind the bipartisan...more

ACA Risk Corridors Update: Trump Administration Releases 2016 Amounts, Paving the Way for Litigation Over Amounts Owed

by Faegre Baker Daniels on

On November 13, 2017, the Centers for Medicare & Medicaid Services (CMS) announced its Risk Corridors payment and charge amounts for the 2016 benefit year. This event is significant in that it both acknowledges and quantifies...more

Capitol Hill Healthcare Update

by BakerHostetler on

The year-end schedules of the Senate HELP and Finance committees just became more clogged, as the two panels will lead the review of President Trump’s nominee to be Health & Human Services (HHS) secretary. Trump announced...more

Window on Washington - Vol. 1, Issue 34

by Clark Hill PLC on

Short-term Continuing Resolution Likely Needed to Fund Government Past December Deadline: Republicans are focused on tax reform through Thanksgiving, and when lawmakers return from the upcoming holiday recess, they will have...more

A Step Toward ‘Replace' Without the ‘Repeal': The Trump Administration Re-Regulates Obamacare

by Faegre Baker Daniels on

On Friday, October 27, the Centers for Medicare and Medicaid Services (CMS) published its draft annual Proposed Notice of Benefits and Payment Parameters for Calendar Year 2019. This proposal follows on the heels of a Request...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

Expanding Association Health Plans—Which Agencies Need to do What

On October 13th, President Trump signed an Executive Order directing various federal agencies to consider how to achieve three administration health reform objectives: (1) expand access to Association Health Plans (AHPs); (2)...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

Health Reform Rollercoaster

by Winstead PC on

When POTUS signed the most recent executive order related to health care reform, it was only a small incremental step to direct the agencies to loosen some rules on health reform that will eventually impact the coverage...more

2017 End of Year Plan Sponsor “To Do” List (Part 1) Health & Welfare

by Snell & Wilmer on

As 2017 comes to an end, we are pleased to present our traditional End of Year Plan Sponsor “To Do” Lists. This year, we are presenting our “To Do” Lists in four separate Employee Benefits Updates. This Part 1 will cover...more

Association Health Plans—Can The Trump Administration Expand Access Without Congress?

In recent weeks, the Trump Administration has been considering allowing health insurance to be purchased across state lines and expanding access to “Association Health Plans” (AHPs) that could take economic advantage of...more

Manatt on Health: October 2017

Massachusetts Waiver Amendment Requests Partial Expansion and Closed Formulary - On September 8, 2017, Massachusetts submitted a waiver amendment request to the Centers for Medicare & Medicaid Services (CMS) to modify its...more

Window On Washington - This Week in the Nation's Capital - Issue 29

by Clark Hill PLC on

Hurricane Supplemental Includes $29B for Disaster Aid and Flood Insurance: Of the $29B, the National Flood Insurance Program will receive $16B to pay flood claims. The House plans to pass the bill next week and the Senate the...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

Trump Administration Seeks Stakeholder Input on New Direction

by K&L Gates LLP on

On September 20, 2017, the Centers for Medicare and Medicaid Services (“CMS”) released an informal request for information (“RFI”) seeking stakeholder feedback on the future direction of the Center for Medicare and Medicaid...more

Capitol Hill Healthcare Update

by BakerHostetler on

With congressional Republicans’ efforts to repeal the Affordable Care Act (ACA) on hold at least for now, the bipartisan leaders of the Senate HELP Committee are seeking to rekindle their work to shore up the health law’s...more

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