News & Analysis as of

Healthcare Consolidated Appropriations Act (CAA)

Manatt, Phelps & Phillips, LLP

New CMS Guidance on the Provision of Medicaid and CHIP Services to Incarcerated Children and Youth

This is an excerpt from a recent Manatt article published on State Health & Value Strategies. Click here to download insight. On July 23, 2024, the Centers for Medicare & Medicaid Services (CMS) released a State Health...more

McDermott Will & Emery

Six Wishes for the Forthcoming Final Regulations Under MHPAEA

McDermott Will & Emery on

On July 1, 2024, the US Department of Labor (DOL) submitted final regulations to the Congressional Budget Office (CBO), implementing the Mental Health Parity and Addiction Equity Act (MHPAEA) as most recently amended by the...more

McDermott+

Telehealth: Regulatory Questions Amid Legislative Uncertainty

McDermott+ on

Where has the time gone? We have hit the one-year mark since the end of the COVID-19 public health emergency (PHE). Yes, you read that correctly. One year! One of the long-term consequences of the PHE was the shift in when...more

Bass, Berry & Sims PLC

Welfare Plan Class Action Litigation Underscores Importance of Minding Your Fiduciary Duties

Bass, Berry & Sims PLC on

As mentioned in our recent blog post, the recently filed class action lawsuit against Johnson & Johnson (Lewandowski v. Johnson & Johnson et. al., D.N.J., No. 1:24-cv-00671 (Feb. 5, 2024)) over alleged excessive prescription...more

Akin Gump Strauss Hauer & Feld LLP

Compacts Renewal Ushers in New Era of Relations Between the U.S. and Freely Associated States

When President Biden signed the Consolidated Appropriations Act into law on March 9, he dramatically altered U.S. relationships with the Republic of the Marshall Islands (RMI), the Republic of Palau, and the Federated States...more

Littler

Sponsoring a Group Health Plan for Employees? What Employers Need to Know About the Consolidated Appropriations Act

Littler on

Many employers offer health insurance as a way to recruit and retain talent. Sponsoring a group health plan, however, can subject the employer plan sponsor to significant legal and regulatory burdens deriving from laws such...more

Manatt, Phelps & Phillips, LLP

Continuous Medicaid/CHIP Eligibility for Children and Youth: 2024 Considerations for States

In December 2022, the U.S. Congress took a step to address churn—where enrollees lose Medicaid coverage, often for procedural reasons, and later reenroll after a gap in coverage—in the Consolidated Appropriations Act, 2023...more

McDermott+

Regulatory Reflections from the Past Year

McDermott+ on

As 2023 comes to a close, I can’t help but reflect on all the regulations and policies we reviewed this year (and those that we’ll continue to handle next week before the year actually ends). There were some tasty eggs with...more

Nelson Mullins Riley & Scarborough LLP

CMS Issues Interim Rule in Response to State Medicaid Disenrollment Trend

When the COVID-19 Public Health Emergency (PHE) ended in April 2023, the Families First Coronavirus Response Act’s Medicaid continuous enrollment condition also came to an end. The condition had allowed states to claim a...more

Foley Hoag LLP - Medicaid and the Law

CMS Issues Rule Implementing Medicaid Redetermination Policies

We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of...more

Constangy, Brooks, Smith & Prophete, LLP

Update on Cyber Incident Reporting for Critical Infrastructure Act of 2022

As we near the end of another year, it is time to look ahead to developments in the information security and privacy landscape. One area of particular importance is the development of regulations implementing the Cyber...more

Manatt, Phelps & Phillips, LLP

The Gag Clause Prohibition Compliance Deadline Is Approaching: What Plans and Issuers Need to Know

Last week the Centers for Medicare & Medicaid Services (CMS) reminded health plans and health insurance issuers that the deadline for electronically filing attestations of compliance with the prohibition against so-called gag...more

Ballard Spahr LLP

No Surprises, But Much Uncertainty: The Status of CAA Billing Rules

Ballard Spahr LLP on

Summary - The rules in the Consolidated Appropriations Act that aim to eliminate much of the surprise from billings by out-of-network providers in particular situations are the subject of continued controversy....more

Seyfarth Shaw LLP

Mental Health Compliance Report Issued to Congress Spoiler Alert – Plans All Fail

Seyfarth Shaw LLP on

Seyfarth Synopsis: The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and insurers to cover treatments for mental health and substance use disorders in a manner that is equitable to the...more

Ballard Spahr LLP

Attestation to Consolidated Appropriations Act’s “Anti-Gag Rules” Due by Year’s End

Ballard Spahr LLP on

By December 31, 2023, health plans and insurers must submit an attestation of compliance with the “anti-gag rules” of the Consolidated Appropriations Act of 2021 (CAA). The rules apply to all agreements entered into on or...more

Nelson Mullins Riley & Scarborough LLP

Physician Wellness Program Exception

On Dec. 29, 2022, the Consolidated Appropriations Act (the “CAA”) was signed into law. The CAA provides for a new exception to the Stark Law and Anti-Kickback Statute (the “AKS”). Section 4126 of the CAA introduces a new...more

ArentFox Schiff

Physician Wellness Programs: A New Stark Law Exception and AKS Safe Harbor to Combat Burnout

ArentFox Schiff on

The recently passed Consolidated Appropriations Act (CAA) of 2023 includes a new Stark Law exception and Anti-Kickback Statute (AKS) safe harbor, allowing hospitals and other health care entities to offer their physicians...more

Snell & Wilmer

Five Facts About the Annual Gag Clause Prohibition Compliance Attestation

Snell & Wilmer on

Effective December 27, 2020, the Consolidated Appropriations Act, 2021 (“CAA”), as part of its transparency in health care protections, prohibits group health plans and issuers from entering into agreements that directly or...more

McDermott Will & Emery

Congress Adds AKS and Stark Law Exceptions for Certain Wellness Programs

As a part of the Consolidated Appropriations Act, 2023 (CAA), Congress passed new exceptions to the Physician Self-Referral Law (Stark Law) and the federal Anti-Kickback Statute (AKS) allowing certain healthcare entities to...more

Epstein Becker & Green

Hidden in Plain Sight: Lesser-Known Exceptions Recently Adopted by Congress to the Federal Physician Self-Referral Law and...

Epstein Becker & Green on

At the end of 2022, Congress enacted the Consolidated Appropriations Act of 2023 (“CAA”), for which there has been much fanfare.   As it relates to health care, this legislation included provisions addressing issues such...more

King & Spalding

CMS Issues IPPS and LTCH Proposed Rule for FY 2024

King & Spalding on

On April 10, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for Fiscal Year (FY) 2024 (the Proposed Rule). In the...more

Bass, Berry & Sims PLC

HHS-OIG Year in Review - 2022

Bass, Berry & Sims PLC on

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) continues to offer valuable insights to the healthcare industry as to how best to approach increasingly complex healthcare fraud...more

Foley & Lardner LLP

Key Takeaways from the Foley/PYA “Let’s Talk Compliance” 2-Day Virtual Conference

Foley & Lardner LLP on

Session #1: State of the Healthcare Industry Effective Compliance Plans and Enforcement Trends - In their discussion of compliance program effectiveness and enforcement, attorneys Kolarik and Waltz and Ms. Sumner...more

Snell & Wilmer

High Deductible Health Plan Telehealth Relief, Extended Again!

Snell & Wilmer on

If you sponsor a high deductible health plan (“HDHP”) and have been tracking telehealth relief, your head may be spinning and rightfully so! There have been various laws and guidance impacting HDHPs and telehealth since 2020...more

Foley & Lardner LLP

What’s Next in Washington? - January 2023 Edition

Foley & Lardner LLP on

The dust from the 2022 Midterm Elections has settled and the 118th Congress has begun. Republicans were successfully able to flip control of the House and now have a 222-212 majority with one vacancy to be filled. Democratic...more

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