News & Analysis as of

Premiums Healthcare Centers for Medicare & Medicaid Services (CMS)

Manatt, Phelps & Phillips, LLP

States Challenge CMS Rule Making DACA Recipients Eligible for Marketplace Subsidies

On August 8, a coalition of 15 state attorneys general sued CMS in the North Dakota federal court seeking to overturn a May 2024 CMS final rule making Deferred Action for Childhood Arrivals (DACA) recipients eligible for...more

Manatt, Phelps & Phillips, LLP

D.C. Court Strikes Down Indiana 1115 with Premiums and Coverage Restrictions

On June 27, the D.C. District Court struck down CMS’ 2020 approval of a 10-year renewal for the Healthy Indiana Plan (HIP) 2.0 Medicaid Section 1115 demonstration (Rose v. Becerra). In addition to the atypical 10-year...more

Nossaman LLP

Understanding the HHS 2023 Proposed Rule

Nossaman LLP on

The Department of Health and Human Services (HHS) released its Notice of Benefit and Payment Parameters for the 2023 Proposed Rule on Wednesday, January 5th 2022. ...more

Burr & Forman

2016 Health Care Year in Review

Burr & Forman on

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - November 2016

Minnesota’s Governor and legislators propose financial assistance options for on- and off-Marketplace individual coverage; Vermont receives final federal approval for the country’s first all-payer ACO model; and a report...more

Manatt, Phelps & Phillips, LLP

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

HealthCare.gov consumers begin previewing 2017 coverage options as HHS projects a 9% enrollment increase over last year and an average 22% benchmark premium increase; Oregon study finds increased primary care spending in...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - September 2015

CMS permits states to use income information from other means-tested benefit programs for Medicaid eligibility determinations; Alaska’s Medicaid expansion is given the green light to launch today; and Washington State submits...more

Akerman LLP - Health Law Rx

CMS Now Requiring Qualified Health Plans To Accept Premium Payments From Certain Third Parties

As previously reported on November 13, 2013 and February 20, 2014, the Centers for Medicare and Medicaid Services ("CMS") has attempted to provide guidance as to when it is appropriate for issuers of "qualified health plans"...more

Cozen O'Connor

Health Care Reform Implementation Update - December 19, 2013

Cozen O'Connor on

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

Baker Donelson

May Providers Pay Health Insurance Premiums for HealthCare.gov Plan Enrollees?

Baker Donelson on

Following last week's declaration that Qualified Health Plans (QHPs) on HealthCare.gov are not "Federal health care programs," and thus are not subject to the federal Anti-Kickback Statute, CMS released additional guidance...more

Baker Donelson

Dodging the AKS: Marketplace Plans Are Not "Federal Health Care Programs"

Baker Donelson on

In an October 30th letter addressed to Congressman Jim McDermott, the Department of Health and Human Services (HHS) Secretary, Kathleen Sebelius, left little to interpretation: Qualified health plans (QHPs) purchased through...more

King & Spalding

CMS Attributes Significant Out-of-Pocket Savings for Medicare Beneficiaries to Health Care Reform Efforts

King & Spalding on

On October 28, 2013, CMS announced that Medicare beneficiaries are realizing significant out-of-pocket savings as a result of health care reform efforts. The savings are based on cumulative savings in the prescription drug...more

Manatt, Phelps & Phillips, LLP

Insights on Arkansas’s “Private Option” Medicaid Expansion

On September 27, 2013, the Centers for Medicare and Medicaid Services (CMS) approved Arkansas’s waiver to implement the Affordable Care Act (ACA) Medicaid expansion by using premium assistance to purchase QHPs in the Health...more

Manatt, Phelps & Phillips, LLP

Healthcare Law -- Sep 26, 2013

Engaging Consumers to Improve Integrated Care Models - Integrated care is a growing trend in health reform, as states seek to improve care quality, health outcomes and patient satisfaction while containing healthcare...more

Cozen O'Connor

Health Care Reform Implementation Update - September 24, 2013

Cozen O'Connor on

With a week until a potential government shutdown and a week until open enrollment begins, the Affordable Care Act (ACA) is in the limelight. On September 20, the House voted for a continuing resolution that funds the...more

Mintz - Health Care Viewpoints

Health Care Reform Update -- June 17th, 2013

In This Issue: Leading the News; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; Other Health Care News; and Hearing and Mark-Ups Scheduled. Excerpt from Leading the News...more

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