News & Analysis as of

Health Insurance

Memo to Massachusetts Employers for 2018 and 2019: How Not to Comply with the EMAC New Rules

In a November 20, 2017 post, we reported on Massachusetts’ passage of H. 3822, “An Act Further Regulating Employer Contributions to Health Care,” (the “Act”), the purpose of which is to shore up the finances of the...more

Telehealth Opportunities Worth Watching in 2018

Continued physician shortages, reduced reimbursement from government and private insurance plans and the ever-increasing health care needs of an aging population are forcing payors and providers alike to increase the...more

Medicare's Part B Premium Will Be Unchanged in 2018, But Many Will Pay More. Got That?

The announcement of the 2018 Medicare premium is good news for some beneficiaries and bad news for many others. The good news is that the standard monthly Part B premium, which about 30 percent of Medicare beneficiaries pay,...more

Health Alert (Australia) 11 December 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 1 December 2017 - Laerdal Medical Pty Ltd and Comptroller-General of Customs AATA 2427 - CUSTOMS – whether subject goods accessory –...more

Medicaid Expansion May Reduce Medical Divorce Rates

Medical divorce is a term coined some years ago to describe a divorce obtained for medical reasons. More specifically, according to an article by George Diepenbrock, researchers defined “medical divorce” as “an instance where...more

Massachusetts Health Care Update: Senate Bill, Medication Switching, and Opioids

by Mintz Levin - ML Strategies on

Massachusetts policymakers continue to debate health care reform proposals with important implications for industry stakeholders. This month the Senate passed sweeping health care reform legislation, a special commission held...more

Tennessee Supreme Court Rejects Efforts to Alter Existing Law on the Collateral Source Rule in Personal Injury Cases

Last month the Tennessee Supreme Court, in Dedmon v. Steelman, affirmed the long-standing collateral source rule in personal injury cases. As long as an injured plaintiff can establish that the medical expenses they incurred...more

Through a Glass Darkly: The Latest Health Care Deals Signal a Further Shift in Control and the Locus of Care

by Epstein Becker & Green on

Two merger announcements this week—one concerning CVS’s intention to acquire Aetna and the other concerning United/Optum’s intention to acquire DaVita’s physician group—have health investors and strategists peering over the...more

Watch out for IRS letters: IRS Begins Enforcing Employer Mandate

by FordHarrison on

The IRS has recently begun enforcing the “employer shared responsibility” (ESR) provisions of the Affordable Care Act (the "Act"), which require employers having 50 or more full-time employees (or full-time equivalent...more

‘Tis the Season for ACA Penalties

by Polsinelli on

After several years of uncertainty surrounding enforcement of the Patient Protection & Affordable Care Act of 2010’s so-called “employer mandate,” the Internal Revenue Service (IRS) has begun assessing penalty notices for the...more

CVS Health to Acquire Aetna

On December 3, 2017, CVS Health, a giant in the retail pharmacy industry, announced plans to acquire Aetna. Aetna is one of the largest medical insurers in the nation, servicing approximately 46.7 million people. Under the...more

Health Alert (Australia) 4 December 2017

by DLA Piper on

In This Issue: - Judgments; Legislation; and Reports. - Excerpts from Judgments: 30 November 2017 - Health Services Union NSW v Health Secretary [2017] NSWSC 1661 INDUSTRIAL LAW – declaratory relief – Clause 17...more

Employee Benefits Developments - November 2017

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of November 2017. Minimum Required Distributions – IRS Guidance for Handling Missing Participants - Missing...more

Tax bill will have big health care effects, none of them good

It may take days, weeks, years, or even a decade to fully determine what the Republicans in Washington have done to the nation’s health care with the U.S. Senate’s middle-of-the-night approval of more than $1 trillion in...more

The Friday Five: Five Current ERISA Litigation Highlights

On November 29, 2017, the Department of Labor (DOL) further delayed and extended the applicability date of the 2016 Final Rule amending claims procedures for ERISA-covered employee benefit plans. Previously, the Final Rule...more

CMS Waives Medicaid Retroactive Eligibility For Iowa: Is Your State Next?

by Cozen O'Connor on

Since 1973, the Social Security Act has mandated that states provide retroactive Medicaid benefits for three months prior to the individual’s application. SSA § 1902(a)(34). Congress enacted this provision to provide...more

Watch Your Mail: IRS Begins Collection of Employer Mandate Penalties

by Foley & Lardner LLP on

It’s official. The IRS has finally begun the process of collecting penalties under the Affordable Care Act’s (“ACA”) employer shared responsibility provisions, better known as the “employer mandate.” The IRS has started...more

President Trump Once Again Attempts To Dismantle The Affordable Care Act

by Fisher Phillips on

After multiple failed attempts by Congress to reform the Affordable Care Act (ACA), President Trump announced several weeks ago that the federal government would stop making subsidy payments to insurers who sell coverage...more

Your Not So Kind (Or Welcome) Early Holiday Gift From The IRS: Letter 226j

by Jackson Lewis P.C. on

On more than one occasion since passing the Affordable Care Act (“ACA”), the IRS has given some type of early holiday “gift” to alleviate pending compliance concerns for employers. One of the most significant of these...more

Alert: Employers Beware: The IRS Has Begun Enforcing Employer Penalties Under the ACA

by Cooley LLP on

Businesses should be aware that the IRS has initiated enforcement of the employer shared responsibility provisions of the Affordable Care Act (the "Act") – which could mean your business is about to receive (if it hasn’t...more

Brace for Impact: IRS Says ACA Employer Mandate Penalties Coming

by Fisher Phillips on

The IRS quietly revised its FAQ on employer shared responsibility provisions under the Affordable Care Act (ACA) in November, adding a bombshell statement that it plans to inform employers of their “potential liability for an...more

HHS Nominee Alex Azar Testifies Before Senate HELP

by Holland & Knight LLP on

The Senate Health, Education, Labor, & Pensions (HELP) Committee held the first hearing on the confirmation for Secretary of Health and Human Services (HHS) nominee Alex Azar on Wednesday, November 29. Notably, only the...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

Medicare Providers Face December 1 Deadline to Request Review of Medicare Payment Adjustments

by Akerman LLP - Health Law Rx on

Providers have just a couple more days to challenge Medicare’s proposed 2018 value modifier payment adjustments. On September 18, 2017, Medicare released quality reports and measures used to calculate quality-based payment...more

Connecticut District Court Provides Interpretation of ACA Provision - Decision Allows Insurers to Circumvent Hospitals in...

by Holland & Knight LLP on

• The ACA does not prevent insurers from declining to directly reimburse out-of-network hospitals for emergency care, and instead adjudicate and administer claims directly with individual patients, the U.S. District Court for...more

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