News & Analysis as of

Out-of-Pocket Expenses

OIG Issues Letter Declining to Impose Administrative Sanctions for Provision of Certain Free Drugs

by Holland & Knight LLP on

On Jan. 4, 2018, the HHS Office of Inspector General (OIG) issued an open letter containing guidance regarding the provision of certain free drugs to federal healthcare program beneficiaries. Specifically, the OIG stated that...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

Trigger for Hurricane and Named Storm Deductibles

Recent damage from Hurricanes Harvey, Irma, and Maria have focused attention on special “named storm” and “hurricane” deductible endorsements found in most property insurance policies issued for coastal areas. Such...more

Tax Credits/Solar Energy: Arizona Appellate Decision Describing Purchasers' Breach of Contract Action

An October 16th Arizona Court of Appeals decision describes a breach of contract action in a lower court involving the purchase of a residential solar energy system. See Lakosky v. The Solar Store, LLC, 2017 WL 4614724....more

New California Law Limits Drug Manufacturer Co-Pay Cards and Other Discounts in California

by Hogan Lovells on

In the most recent salvo by states eager to show an effort to contain prescription drug costs, California's governor has signed into law a bill that will prohibit, with some limited exceptions, pharmaceutical manufacturers...more

Can Employees Pay for Cord Blood Storage with an HRA, FSA or HSA?

The blood remaining in the umbilical cord after childbirth contains stems cells which may be used in a variety of medical treatments. Many parents of newborns are seeking to save this “cord blood”, either with the hopes of...more

Updated Health Care Reform Legislation Comparison Chart

The chart below compares key provisions of the Affordable Care Act (ACA), the American Health Care Act (AHCA) and the Better Care Reconciliation Act (BCRA). This chart is current as of July 13, 2017, and as of that date,...more

Are You Ready for AB 72?

by Buchalter on

To protect patients from receiving an unexpected surprise bill when they seek care at in-network facilities from out-of-network providers, Governor Brown signed AB 72: California’s surprise out-of-network law. The new law...more

When your Hospital-of-Choice is In-Network but, SURPRISE, your Anesthesiologist is Not: California’s AB-72 and Other State...

Regardless of a patient’s diligence in selecting an in-network hospital, ambulatory surgery center, or other health facility for treatment, patients are still being saddled with surprisingly high medical bills that include...more

What Are the New 2018 Health Savings Account Limits?

by McDermott Will & Emery on

In Revenue Procedure 2017-37, 2017-21 IRB, the IRS issued the annual inflation-adjusted contribution, deductible and out-of-pocket expense limits for 2018 for HSAs. For clear comparison, we have outlined the changes from 2017...more

Data Breach Lawsuit Survives Motion to Dismiss

by Bracewell LLP on

In an April 13, 2017 decision in Walters v. Kimpton Hotel, a California federal judge rejected the bid of hotel chain Kimpton Hotel and Restaurant Group, LLC to dismiss a proposed class action arising from a data breach last...more

Manatt on Health Reform: Weekly Highlights - April 2017

Consumers could use Marketplace subsidies to purchase off-Marketplace plans under proposed Senate bill; Oklahoma and Massachusetts will pursue Medicaid and Marketplace waivers; and a Medicaid expansion bill fails in Kansas...more

Obamacare Reform Watch: Reimbursement Strategies in an Environment of Growing Out-of-Pocket Costs and an Expanding Self-Pay...

by Hinshaw & Culbertson LLP on

The increase in patient financial responsibility for health care costs in the past ten years has outpaced consumer growth in wages. This escalation of out-of-pocket costs represents a major revenue cycle challenge for health...more

Top 9 Mini Tort facts for repairing car accident vehicle damage

by Michigan Auto Law on

What you need to know on the Michigan Mini Tort maximum recovery limit, getting your car fixed and paid for, what do do if you’re in a crash with an uninsured driver, time limits to file a claim....more

Why Having A “Gifted” Child In NJ May Cost You More Child Support

by Cozen O'Connor on

The benefits of enrolling children in extracurricular activities are endless. Not only do they learn how to play a sport or musical instrument, but also soft skills and valuable life lessons, such as teamwork, the importance...more

Is It Compensation Or Loan Repayment?

by Pessin Katz Law, P.A. on

In Scott Singer Installations, Inc., (TC Memo 2016-16, filed August 24, 2016)1, the U.S. Tax Court (the “Court”) ruled that the bulk of payments made to a sole shareholder of an “S” Corporation, characterized as reimbursement...more

Client Alert: IRS Announces Increases for Health FSAs and HSAs

by Fraser Trebilcock on

The IRS has just released its 2017 annual inflation adjustments, in which it announced that the dollar limitation under Code section 125 on voluntary employee salary reductions for contribution to health flexible spending...more

Despite Plaintiffs Satisfying Standing Requirements, Barnes & Noble Closes the Book on Data Breach Class Action

by Reed Smith on

In data breach class actions, standing is often the major obstacle, and has taken on renewed focus following the U.S. Supreme Court’s ruling in Spokeo v. Robins, 136 S. Ct. 1540 (May 24, 2016). See, e.g., Federal Court Finds...more

Manatt on Health Reform: Weekly Highlights - September 2016 #3

Study finds that Marketplace premiums are lower than employer-based premiums, even without federal subsidies; New York regulators move to shield insurers from outsized federal risk adjustment payments; and Missouri will seek...more

California puts curbs on surprise medical bills

Surprise! California lawmakers waited until the very end of their legislative session before joining an increasing number of states in protecting patients from unexpected out-of-network medical charges. As many as 70 percent...more

Manatt on Medicaid: Monthly Expansion Recap - August 2016

California - Medicaid Enrollees Are Largest Share of Newly Insured - A new survey from the Kaiser Family Foundation found that 33% of Californians uninsured in 2013 are now enrolled in Medi-Cal, the State’s Medicaid...more

Manatt on Health Reform: Weekly Highlights - August 2016 #4

HealthCare.gov plans an open enrollment pilot that will let consumers compare provider network breadth; new Medicaid enrollees reduce out-of-pocket spending on prescription drugs by nearly 60%; and Kansas’s Governor announces...more

You Are the Victim of Defamation: Should You Sue?

It is not unusual to get a telephone call from a client or prospective client (let’s call him John), who says, “Somebody is saying false things about me. I want it to stop, I want an apology, and I want damages.”...more

Manatt on Health Reform: Weekly Highlights - August 2016 #2

CMS targets Medicaid managed care pass-through payments; California proposes “California Qualified Health Plans” for the undocumented; and a new study finds out-of-pocket costs were reduced by nearly a third for Medicaid...more

Manatt on Health Reform: Weekly Highlights - July 2016 #4

CMS’ increase of the “income verification threshold” makes eligibility determinations easier for consumers; Oregon CO-OP policyholders can credit out-of-pocket spending towards new plans; and report finds that 13 million...more

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