News & Analysis as of

Penalties Healthcare

Beware: IRS To Begin Issuing ACA Employer Shared Responsibility Payment Penalty Notices

The IRS has announced its next steps regarding the Employer Shared Responsibility Payments (the “ESRPs”), which are the ACA penalties assessable to “Applicable Large Employers” for failing to provide affordable health care...more

Lack of Timely Action and Knowledge of Risk Results in $3.2 Million Civil Monetary Penalty for HIPAA Violations

Children’s Medical Center of Dallas (Children’s) was hit with a $3.2 million civil penalty from the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) for failing to take steps to properly protect...more

FCPA Recidivists: Orthofix (Part II of II)

by Michael Volkov on

In its continuing quest to push the message of aggressive FCPA enforcement, the SEC resolved FCPA charges against Orthofix, a medical device company, for $6 million in penalties and disgorgement. In a related action, the SEC...more

Small Employers Cheer Recently Eased Affordable Care Act Restrictions

by Cozen O'Connor on

On December 13, 2016, President Obama signed the 21st Century Cures Act (the Act) that provides government funding and support for a number of health care initiatives. Significantly, the last section of the Act eases...more

MACRA: Top 10 FAQs

by Carlton Fields on

Significant changes to the Medicare payment system are underway. The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) is set to take effect January 1, 2017. MACRA represents a deliberate departure by the...more

The Department of Justice Ups the Ante: Per Claim Penalties for False Claims Act and Anti-Kickback Statute Violations Nearly...

by Sherman & Howard L.L.C. on

On June 30, 2016, the Department of Justice (“DOJ”) published an interim file rule that dramatically increases the per claim penalties for violations of the False Claims Act (“FCA”) and the Anti-Kickback Statute (“AKS”) among...more

Health Care E-Note - December 2015

by Burr & Forman on

A little-noticed provision in the federal Bipartisan Budget Act of 2015 calls for OSHA to increase its penalties to adjust for inflation for the first time since 1990. Please see full E-Note below for more...more

Record-breaking FCA settlements underscore importance of Stark Law compliance

by Thompson Coburn LLP on

In September and October, the Department of Justice (DOJ) announced four record-breaking False Claims Act settlements – ranging from $25 million to $115 million – involving health care systems that allegedly made improper...more

CMS Proposes Sweeping Changes to Medicare Reimbursement for Clinical Diagnostic Laboratory Tests

by King & Spalding on

First Data Collection Period for Clinical Laboratories Is July 1, 2015 to December 31, 2015 - In the October 1, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule...more

Florida Nursing Home Pays Record Settlement to Resolve Federal Anti-Kickback Case

In a recent case Hebrew Homes Health Network, Inc. and its former president and executive Director agreed to pay $17 million to settle allegations that Hebrew Homes violated the federal anti-kickback statute. According to the...more

The Affordable Care Act’s Reporting Requirements for Carriers and Employers (Part 2 of 24): Yikes! The Costs of Failing to Comply...

The Affordable Care Act (ACA) imposes information reporting rules on providers of minimum essential coverage, e.g., insurance carriers and self-funded plans, and on applicable large employers, i.e., those employers that are...more

Employer Shared Responsibility Payments and Reporting Requirements Under the Affordable Care Act: Code Sections 6055 and 6056

by McDermott Will & Emery on

Employer Shared Responsibility Penalties - There are two types of employer shared responsibility payments, also known as pay or play penalties, under the Affordable Care Act (ACA). The first penalty under Internal...more

Circuit Court Split on ACA Could Impact Employer Penalties

In conflicting opinions released on July 22nd, two federal circuits split on whether Affordable Care Act subsidies are available under a federally operated health insurance exchange. “Pay or play” penalties apply only if...more

Halifax Health Gets In More Hot Water

by Faegre Baker Daniels on

You probably didn’t think Florida’s Halifax Health could make its situation any worse. After all, only two months ago Halifax agreed to pay $85 million to settle just the first half of a Medicare fraud case. That still...more

Overview of Primary Provisions of U.S. and French Sunshine Reporting Requirements

by Reed Smith on

2013 was a year of unprecedented scrutiny of financial relationships between manufacturers and health care professionals, such as physicians. Both the United States and France imposed sweeping new reporting and disclosure...more

ACA, HIPAA, COBRA and HSA Penalties: What Do They Mean?

by Dickinson Wright on

What do all of these acronyms stand for and why do employers and human resource professionals care? These acronyms stand for statutory requirements which apply to employer-provided health plans and stiff penalties can apply...more

March and April 2014 Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

by King & Spalding on

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties and excise taxes. To...more

2014 Labor & Employment Law Update: Recent ACA Developments

by Burr & Forman on

In This Presentation: - Current State Of Health Care Reform - How Long are the Obamacare Regulations? - Delayed . . . - Not Delayed . . . - The New Model for Health Insurance Coverage - Individual...more

Failure to Provide COBRA Notice May Not Result in Penalties

by Davis Brown Law Firm on

Occasionally employers who act as the plan sponsor of a group health plan discover that they have neglected to send a “COBRA notice” to an employee who has been terminated. Recent Federal Court decisions within the Eighth...more

Who Is a Full-Time Employee Under the Affordable Care Act?

by PretiFlaherty on

Beginning January 1, 2015, the large employer mandate of the Affordable Care Act (ACA) requires that all full-time employees be offered minimum essential, affordable coverage. Penalties will be assessed for each month that a...more

DHHS Blunder Could Cost Millions! “Oops I Did It Again!”

by Williams Mullen on

We can add one more “oops” to the Department of Health and Human Services (DHHS) repertoire of “oopses.” I am reminded of Captain Edward Smith when he banged the Titanic into an iceberg. Talk about an “oops” moment. Not to...more

Avoiding Mistletoe Mishaps, Part II: Do I Have To Offer Health Care Coverage To My Seasonal Employees?

As 2013 comes to an end, we are considering a number of issues that employers might be facing at the end of the year. Our year-end blog series will cover issues such as seasonal hiring, religious discrimination claims...more

The ERISA Litigation Newsletter; November 2013

In This Issue: - Labor and Employment and ERISA Class Actions After Wal-Mart and Comcast — Practice Points for Defendants (Part I – Commonality)* - Agencies Release Guidance on HRAs, FSAs, and Employer Payment...more

Health Care Reform Provisions For 2014 And Beyond

by FordHarrison on

Executive Summary: Earlier this year, the Obama Administration delayed implementation of the employer mandate, a major provision of the 2010 health care reform law (the Affordable Care Act or "ACA"). The delay of the...more

November and December Filing and Notice Deadlines for Qualified Retirement and Health and Welfare Plans

by King & Spalding on

Employers and plan sponsors must comply with numerous filing and notice deadlines for their retirement and health and welfare plans. Failure to comply with these deadlines can result in costly penalties and excise taxes. To...more

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