On January 10, 2014, CMS will publish the proposed rule titled Medicare Program: Contract Year 2015 and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). The Proposed Rule propositions extensive reforms to the Medicare Advantage (“Part C”) and Medicare Prescription Drug Benefit Program (“Part D”), partly through … Continue Reading
With approximately two months having passed since the end of the government shutdown, the fundamental question still remains; what exactly did Congress achieve through the contentious shutdown negotiations? The shutdown was spurred in part by certain Congressional Members’ opposition to the funding and implementation of the Affordable Care Act (“ACA”). A centerpiece of these oppositional … Continue Reading
Last Wednesday, September 18, 2013, Walgreen Company (“Walgreen”) announced its plan to move approximately 160,000 employees to Aon Hewitt’s private health exchange (the “Aon Exchange”) in 2014. This move marks a significant decrease in risk for Walgreen as the company will shift to a defined contribution model for funding its employees’ health insurance. Under the … Continue Reading
Last Thursday, September 12, 2013, the Department of Health and Human Services (“HHS”) reported that the rate review provisions (the “Rate Review Provisions”) of the Affordable Care Act (“ACA”) saved an estimated $1.2 billion on health insurance premiums in 2012 for 6.8 million policyholders. The Rate Review Provisions are intended to increase transparency behind premium … Continue Reading
After a quiet fall, one of the lawsuits challenging the constitutionality of PPACA has new life. In a brief order, the U.S. Supreme Court has sent the Liberty University v. Geitner case to be heard again by the Fourth Circuit Court of Appeals out of Richmond, Virginia. As the AP mentioned in its piece run by the Washington … Continue Reading
On Thursday, November 15, 2012 at 12:00 Eastern, Squire Sanders, in conjunction with Southwind and Willis Group’s Health Care Practice, will be presenting a free 1-hour webinar on “Addressing Enterprise Risk After the Affordable Care Act” as part of our on-going What Keeps You Up at Night series. View the event webpage for more information or to … Continue Reading
The U.S. Supreme Court has completed announcing its decisions for today, and still no decision on PPACA (Department of Health and Human Servs. v. Florida (No.11-398) and National Federation of Independent Business v. Sebelius (No. 11-393)). The Court is sitting again on Thursday and will likely announce decisions in the remaining cases from this term … Continue Reading
As we get closer to receiving a decision from the U.S. Supreme Court on the constitutionality of PPACA and its individual insurance mandate, three major insurers have committed to continue some benefits that were required by PPACA. These announcements address some of the uncertainty being experienced by insureds who don’t know what will happen or how quickly changes … Continue Reading
On February 16, CMS published a proposed rule regarding providers’ obligation to return any overpayments within 60 days of identifying such overpayment. The proposed rule expounds on 60-day repayment obligation, which became effective in 2010 with the passage of PPACA, in ways that may give providers comfort in some areas but that will likely lead to … Continue Reading
Today, the Eleventh Circuit issued a whopping 300-page opinion holding PPACA’s individual insurance mandate unconstitutional, in Florida v. HHS, siding with the numerous States that filed or have since joined the case. This is directly contrary to the Sixth Circuit’s June 26 decision in the Thomas Moore case, holding that the statute was constitutional. Notably, both courts delivered divided 2-1 opinions. … Continue Reading
The proposed CMS rules for accountable care organizations have only been out a few hours and even the speediest readers are still plowing through them, but a few initial observations are in order: CMS is admitting it needs more than the usual amount of public comment to craft final rules. Perhaps this was intentional but … Continue Reading
We are beginning to see action (and divergent results) on the various court challenges to PPACA, starting with two recent decisions. As explained in SSD’s Sixth Circuit Blog, the federal court for the Western District of Michigan dismissed the case of Thomas More Law Center, et al. v. Obama (E.D. Mich., Case No. 10-CV-11156) (PDF) that challenged whether Congress has authority … Continue Reading