News & Analysis as of

Healthcare Patient Protection and Affordable Care Act (PPACA)

Seyfarth Shaw LLP

What To Do When Your Healthcare Employee Objects To Providing Treatment Based on Religious Grounds

Seyfarth Shaw LLP on

Seyfarth Synopsis: With the myriad claims for religious accommodation that came out of mandatory COVID vaccination policies, employers have become familiar how to handle requests for religious accommodation in the workplace. ...more

Ballard Spahr LLP

Health Plan Compliance Deadlines Draw Near

Ballard Spahr LLP on

Regulations under Section 1557 of the Affordable Care Act and HIPAA will require health plans and health care providers to take action in the coming months to meet new requirements. Health plan sponsors and providers that...more

Alston & Bird

Health Care Week in Review: Biden Administration Announces $100 Million for ACA Marketplace Navigators and $81.3 Million for...

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Baker Donelson

60 Days After Loper: Health Care Impact of Chevron Deference's End

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The Supreme Court of the United States issued its highly anticipated ruling in a pair of cases challenging the long-standing Chevron doctrine on June 28, 2024. Foreshadowed by decisions in recent years slighting Chevron, it...more

Mintz - Health Care Viewpoints

2024 Pre-Election Analysis: Health Care Issues

In recent elections, health care has been one of the most hot-button issues with consequences for millions of Americans, and this election is no exception. The next administration and the 119th Congress have the potential to...more

Epstein Becker & Green

Affordable Care Act Overpayments in the CY 2025 Medicare Physician Fee Schedule Proposed Rule: Implications for False Claims

Epstein Becker & Green on

Stakeholders are continuing to analyze the implications of the mammoth proposed rule on “Medicare and Medicaid Programs: [Calendar Year (CY)] 2025 Payment Policies under the Physician Fee Schedule and Other Changes to Part B...more

Proskauer - Employee Benefits & Executive...

More on Braidwood: ACA Preventive Services Mandate Remains Mostly in Place (For the Time Being)

At the end of June, the U.S. Court of Appeals for the Fifth Circuit affirmed a district court order invalidating the Affordable Care Act preventive services mandate for “A” or “B” items and services recommended by the United...more

ArentFox Schiff

The Accelerating Kids’ Access to Care Act: Breaking Barriers for Pediatric Patients Across State Lines

ArentFox Schiff on

In July 2023, US Senators Michael Bennet (D-CO) and Chuck Grassley (R-IA), along with US Representatives Lori Trahan (D-MA) and Mariannette Miller-Meeks (R-IA), introduced legislation to improve access to critical care for...more

Hall Benefits Law

HHS Issues Proposed Rule on Nondiscrimination in Health Programs and Activities

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” The proposed rule, designed to advance health equity and protect people from...more

Ballard Spahr LLP

Final Section 1557 Rules: Highlights for Health Plan Sponsors

Ballard Spahr LLP on

The U.S. Department of Health and Human Services (HHS) has issued final regulations on the nondiscrimination rules set forth in Section 1557 of the Affordable Care Act. The new rules apply to certain group health plans, as...more

Quarles & Brady LLP

Is Your Employee or Contractor Excluded?

Quarles & Brady LLP on

Employers must check its employees, contractors and vendors to see if an individual or organization is excluded from participating in federal and/or state programs. While there are a variety of exclusion programs at the...more

Troutman Pepper

Tennessee and Mississippi AGs Sue the HHS Over New Antidiscrimination Rule

Troutman Pepper on

Tennessee and Mississippi attorney generals (AG), joined by 13 other states, filed a multistate lawsuit in the Southern District of Mississippi. The lawsuit challenges the U.S. Department of Health and Human Services’ (HHS)...more

Verrill

Can a Self-Funded Group Health Plan Exclude Coverage for Gender-Affirming Care?

Verrill on

We are sometimes asked whether a self-funded group health plan is required to cover gender-affirming medical services. As this post explains in detail, it is generally impracticable for a self-funded ERISA-covered plan to...more

Holland & Hart LLP

New ACA 1557 Non-Discrimination Rules: Checklist For Healthcare Providers

Holland & Hart LLP on

On May 6, 2024, the Department of Health and Human Services (HHS) published its final rule revamping the non-discrimination regulations issued under § 1557 of the Affordable Care Act.  The revised rules apply to all...more

Sheppard Mullin Richter & Hampton LLP

DHHS Bolsters Non-Discrimination Protections for Recipients of Covered Health Care Services and Activities

In a Final Rule issued on May 6, 2024, the U.S. Department of Health and Human Services (“DHHS”) finalized regulations implementing Section 1557 of the Affordable Care Act (“Section 1557”). The Final Rule updates and...more

Seyfarth Shaw LLP

HHS Issues New Affordable Care Act Section 1557 Nondiscrimination Regulations

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Seyfarth Synopsis: New regulations effective August 6, 2024 restore and expand scope of civil rights protections under Section 1557 of the Affordable Care Act....more

Gardner Law

CMS Audits on the Horizon: Prepare for Increased CMS Audits Under the Sunshine Act

Gardner Law on

Historically, the Centers for Medicare and Medicaid Services (“CMS”) has not aggressively pursued enforcement activity under the Sunshine Act. However, this may change in 2024. Late last year, CMS updated its Open Payments...more

Husch Blackwell LLP

Nondiscrimination in Healthcare: HHS’s New Final Rule Under Section 1557 of the Affordable Care Act

Husch Blackwell LLP on

Section 1557 of the Affordable Care Act prohibits discrimination in healthcare based on a number of characteristics including race, color, national origin, sex, age, and disability. On April 26, 2024, the Department of Health...more

Akerman LLP - HR Defense

On the Basis of Sex… Discrimination in Group Health Plans and What Employers Should Know

In just a few days’ time, recently promulgated federal final rules addressing sex-based nondiscrimination in the administration of health care benefits have created a flurry of healthcare industry activity. The angst arises...more

McDermott Will & Emery

HHS Final Section 1557 Nondiscrimination Regulations: Gender-Affirming Care and the Role of Carriers Under ASO Arrangements

On April 26, 2024, the US Department of Health and Human Services (HHS) issued a final rule (press release, fact sheet, FAQs) (final regulations) reinterpreting Section 1557 of the Affordable Care Act (ACA), which prohibits...more

Sheppard Mullin Richter & Hampton LLP

The Intersection of Artificial Intelligence and Utilization Review

California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the California Medical...more

McDermott Will & Emery

Ten Takeaways From Long-Awaited Section 1557 Nondiscrimination Protections

On April 26, 2024, the US Department of Health and Human Services (HHS) issued a final rule (press release, fact sheet, FAQs) reinterpreting Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination on the...more

ArentFox Schiff

Fourth Circuit Rules that State Health Plans Must Cover Gender-Affirming Care

ArentFox Schiff on

Last week, the US Court of Appeals for the Fourth Circuit issued a decision holding that state health care plans in North Carolina and West Virginia must cover gender-affirming surgeries. A copy of the decision, Kadel v....more

Epstein Becker & Green

Final Medicaid Managed Care Rule Updates Requirements Regarding Access, Finance, and Quality

On April 22, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Medicaid and Children’s Health Insurance Program Managed Care Access, Finance and Quality Final Rule, a final rule that updates several...more

McDermott+

CMS Finalizes Major Reforms to Medicaid, Part 2: Medicaid Managed Care Reg

McDermott+ on

Medicaid Regs Part 2! Last week, Regs & Eggs took a deep dive into the Ensuring Access to Medicaid Services final reg, one of two regs that the Centers for Medicare & Medicaid Services (CMS) released to add new requirements...more

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