News & Analysis as of

Reinsurance Patient Protection and Affordable Care Act (PPACA)

Manatt, Phelps & Phillips, LLP

Innovative 1332 Waivers Proceed in Colorado and Washington

The Biden administration gave its stamp of approval last week to Colorado’s novel waiver under Section 1332 of the Affordable Care Act (ACA) to require premium reductions in a public option program, a first-of-its-kind plan...more

Carlton Fields

Court of Federal Claims Finds HHS Offset Invalid Under Colorado’s Insurance Liquidating Priority Scheme

Carlton Fields on

The U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (HHS) operates the reinsurance and risk-adjustments program for Colorado, including the application of the “netting rule” — a method...more

Manatt, Phelps & Phillips, LLP

Significant Changes Proposed to Medicare Part D Benefit

On May 23, the bipartisan leadership of the House Ways and Means Committee released a four-page draft discussion bill that, if enacted, would make the most significant changes to the Part D benefit since the Affordable Care...more

Locke Lord LLP

Maryland Obtains Waiver for Health Reinsurance Program

Locke Lord LLP on

Maryland officials will formally announce Wednesday that the federal government has approved an ACA state innovation waiver intended to help shore up Maryland’s individual health insurance market, which has suffered from...more

Mintz - Health Care Viewpoints

New Jersey’s Pending 1332 Reinsurance Waiver

At the end of July, CMS approved two Section 1332 State Innovation Waivers submitted by Wisconsin and Maine for the purpose of establishing state reinsurance programs. There has been a flurry of 1332 waiver activity recently...more

Mintz - Health Care Viewpoints

Recent 1332 Waiver and Reinsurance Activity

States are increasingly looking for ways to improve stability in their individual insurance marketplaces. One way is through reinsurance programs – systems in which multiple insurance companies share risk by purchasing...more

Manatt, Phelps & Phillips, LLP

States Choosing Divergent Paths for Individual Market Coverage

With Congress failing to reach agreement on a stabilization package for the individual market and repeal of the individual mandate set to take effect for 2019, states are considering different strategies, some that will...more

Manatt, Phelps & Phillips, LLP

State Reinsurance Programs: 1332 Waiver Considerations for States

The Affordable Care Act was designed in part to help bring stability to the individual health insurance market. But faced with a fluid federal regulatory environment, many states continue to encounter challenges, including...more

Baker Donelson

Prospects for ACA Market Stabilization Measures Remain Uncertain

Baker Donelson on

With ongoing uncertainty and turmoil in the individual health insurance market, Congress has spent weeks debating whether to include a bipartisan Affordable Care Act (ACA) stabilization measure as part of the "must pass"...more

Carlton Fields

Eighth Circuit Upholds Dismissal Of Claim Against Department Of Health & Human Services Under ACA Transitional Reinsurance Program...

Carlton Fields on

Seeking reimbursement of fees paid, allegedly by mistake, under the transitional reinsurance program in the Patient Protection and Affordable Care Act (“ACA”), the trustees of the Twin City Pipe Trades Welfare Fund’s sued the...more

Epstein Becker & Green

26 Days: Congress and Health Care as FY 2017 Comes to a Close

Congress returns from August recess today, facing a daunting workload to complete before the end of the current fiscal year (FY) on September 30. Big picture issues include raising the national debt ceiling and passing a...more

Manatt, Phelps & Phillips, LLP

1332 Edition: Alaska Reinsurance Proposal Approved by Federal Government

On July 11, the federal government announced approval of Alaska’s waiver request under Section 1332 of the Patient Protection and Affordable Care Act for funding in support of the Alaska Reinsurance Program (ARP). The ARP is...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - November 2016 #5

The incoming Trump Administration selects HHS and CMS leadership; Alaska moves forward with its proposed 1332 waiver for its ACA reinsurance program; and a new Manatt Health report considers the role of Medicaid supplemental...more

Manatt, Phelps & Phillips, LLP

Health Update - November 2016

Post-Election Analysis: Healthcare Antitrust in a Trump Administration - In a Republican sweep of all the elected branches of the federal government, Donald Trump won the presidential election and Republicans retained...more

McDermott Will & Emery

IRS Adjusted ACA Fee Amounts for the 2017 Policy or Plan Years

McDermott Will & Emery on

The Patient-Centered Outcomes Research Institute (PCORI) fee was established under the Affordable Care Act (ACA) to advance comparative clinical effectiveness research. The PCORI fee is assessed on issuers of health insurance...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2016

Massachusetts extends coverage of Hepatitis C treatments and New Hampshire extends substance use disorder coverage to more Medicaid enrollees; Alaska’s Medicaid expansion now moves ahead uncontested; and CMS reports...more

Foley & Lardner LLP

Technological and Information Concerns Highlight NAIC Spring 2016 National Meeting

Foley & Lardner LLP on

The National Association of Insurance Commissioners (NAIC) Spring 2016 National Meeting, which was held from April 3 – 6 in New Orleans, offered insight into numerous issues being considered by state commissioners nationwide....more

Alston & Bird

A&B Healthcare Week in Review

Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - July 2015

Ohio passes a budget mandating that the State request a waiver to implement Medicaid Health Savings Accounts; in Nevada, Marketplace enrollees who experienced technical difficulty obtaining coverage are eligible for a...more

Mintz - ML Strategies

Health Care Update - July 2015

Mintz - ML Strategies on

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - June 2015 #4

This week...no clear consensus has emerged among congressional Republicans on how to manage potential King v. Burwell fallout; California will expand Medicaid to undocumented children; and New York is poised to become the...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

This Week: Leading Up to the SCOTUS King v. Burwell Decision... House Votes to Repeal the Medical Device Tax... CMS Announces It Will Bolster Transitional Reinsurance Payments... MedPAC Releases June Report to Congress....more

Ogletree, Deakins, Nash, Smoak & Stewart,...

ACA Fees, and Forms, and Delays, Oh My!

In the latest round of delays under the Affordable Care Act (ACA), the Employee Benefits Security Administration recently announced that the deadline for health plans to provide enrollment information to the transitional...more

Snell & Wilmer

HHS Extends November 17 Deadline to Submit Covered Lives Data under Reinsurance Program

Snell & Wilmer on

The Health Care Reform Act created the transitional reinsurance program, which requires most self-insured health plans to make contributions to HHS for the 2014, 2015, and 2016 calendar years, in an attempt to stabilize...more

Bond Schoeneck & King PLLC

Employee Benefits: The Registration Form For Transitional Reinsurance Program Fees Has Been Issued, and Must Be Submitted By...

The Patient Protection and Affordable Care Act (ACA) created new fees for covered health plans, including transitional reinsurance program fees (TRP Fees) that are designed to stabilize premium increases that are expected to...more

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