News & Analysis as of

Cost-Sharing

Window on Washington - Vol. 1, Issue 38

by Clark Hill PLC on

One Shutdown Averted, Countdown Begins Again: With the government funded through December 22, House and Senate leadership are shifting their focus on how to structure a long-term spending deal that would include an increase...more

Proposed Medicare Advantage and Part D Regulations for CY 2019 – CMS Takes Aim at Drug Prices

The rising cost of drugs in the U.S. is frequently in the news. So it is not surprising that in its contract year 2019 Proposed Medicare Advantage and Part D Regulations (Proposed Rule), the Centers for Medicare & Medicaid...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

CMS Proposes Key Changes to the Medicare Advantage Program

by Hogan Lovells on

On November 16, 2017, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that would revise regulations and clarify requirements for the Medicare Advantage (MA) and Medicare Prescription Drug Benefit...more

The Legality of Cost-Sharing Reduction Payments Under the ACA

Health insurers may have experienced uncertainty in 2017 when they were setting 2018 rates for individual plans sold on federal and state exchanges pursuant to the Affordable Care Act (ACA). One reason may have been the...more

With December Deadlines Approaching, Congress Considers Another Continuing Resolution

by Baker Donelson on

With less than a month remaining before the December 8 deadline for adopting an appropriations deal and the December 15 deadline to lift the debt ceiling, it is increasingly likely that Congress will once again pass a...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

Obamacare Fight Spurs Executive Actions and Legislative Proposal

by Burr & Forman on

The last 30 days have seen efforts by both the executive and legislative branches to improve conditions in the health care insurance markets with the goal of making health insurance more accessible and affordable. Please...more

2017 End of Year Plan Sponsor “To Do” List (Part 2) Annual Cost of Living Adjustments

by Snell & Wilmer on

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

Clean Up on Aisle 12! The Obamacare Pop-Up Store is Open but Stocks are Limited

The fifth Open Enrollment period under the Affordable Care Act (ACA) started on November 1st, and will continue for a scant 45 days ending on December 15, 2017. This year, not only has the Open Enrollment been cut in half,...more

Update #10: Trump Administration Halts Funding of Cost Sharing Reduction Payments to Insurers

by Davis Wright Tremaine LLP on

Earlier in October, the Trump Administration announced it would immediately terminate payments to insurers to offset the costs of ACA-mandated discounts on co-payments and deductibles for low-income consumers. A number of...more

IRS Announces 2018 Cost of Living Adjustments

by Snell & Wilmer on

The IRS recently announced cost-of-living adjustments for 2018 in Notice 2017-64 and related guidance. The key dollar limits for qualified retirement plans and health and welfare plans are noted below....more

K&L Gates Triage: An Insider’s Perspective on the Health Care Debate in Washington, DC

by K&L Gates LLP on

In this episode of Triage, Amanda Makki and Corbin Santo of the K&L Gates Public Policy and Law practice group discuss several fundamental issues that are currently at the center of the health care debate in Washington, DC....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

Health Care Reform Roundup – Issue 10

After months of failed attempts to pass any health care reform legislation, it appears efforts to pass a bipartisan bill to improve the Affordable Care Act (ACA) are picking up steam. Below is a summary of regent health care...more

ACA Dealt Setback By Another Federal District Court

by Roetzel & Andress on

On October 25, 2017, District Court Judge Vince Chhabria of the United States District Court for the Northern District of California denied a request by California, along with 17 other states and the District of Columbia, for...more

CSR Litigation Update: California Court Denies States' Motion for Preliminary Injunction – What Does This Mean for Health...

by Faegre Baker Daniels on

On October 25, 2017, in the case State of California v. Trump, the U.S. District Court for the Northern District of California denied a motion brought by 17 states seeking to order the Trump administration to resume...more

Trump Administration Plan to Cut Off CSR Payments Withstands First Court Review

by Reed Smith on

A Department of Health and Human Services (HHS) decision to discontinue ACA cost-sharing reduction (CSR) payments to insurers offering policies through ACA exchanges has cleared its first legal hurdle, with a U.S. district...more

Senators Lamar Alexander and Patty Murray Reach Deal on Short-Term ACA Stabilization Bill

by King & Spalding on

Last week, Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announced they had reached an agreement on a short-term, bipartisan health insurance...more

Executive Orders May Be Asking Too Much of Regulators

by Carlton Fields on

On October 12, President Trump signed Executive Order 13813, asking the Department of Labor (DOL) to consider allowing small employers to join together to self-insure or purchase insurance as a large group (creating...more

Assessing President Trump’s “Executive Order Promoting Health Care Choice and Competition”

by Epstein Becker & Green on

On October 12, 2017, President Donald Trump signed an executive order (the “Order”) designed to “promote healthcare choice and competition across the United States,” which in effect will allow many Americans to sidestep...more

Trump Administration Will No Longer Make Cost-Sharing Reduction Payments to Insurers; States Sue

by King & Spalding on

On October 12, 2017, the White House press office announced that the Trump Administration would no longer make cost-sharing reduction (CSR) payments to insurers, which it referred to as a “bailout of insurance companies...more

WPI Insider Briefing: Will the New Composition of Federal Agencies Effect Change?

by Littler on

Nine months into President Trump’s term, the pace of nominations and appointments to fill critical position within his administration is accelerating. Action on the nominations to the National Labor Relations Board (NLRB),...more

Alexander, Murray Announce Bipartisan Proposal on Market Stabilization

by Baker Donelson on

On October 17, the Senate Health, Education, Labor and Pensions Committee Chair Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) announced they had agreed on a proposal for a narrow, short-term individual market...more

Window On Washington - This Week in the Nation's Capital - Vol. 1, Issue 31

by Clark Hill PLC on

Senate Adopts Budget Resolution Making Way for Tax Reform: The Senate on a party-line vote of 51-49 adopted its FY18 budget resolution that includes $5.1 trillion in spending reductions and instruction for reconciliation for...more

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