Regional Health Care and Medicare Fraud Prevention Summit Conducted by Attorney General Holder and Secretary Sebelius

From the Department of Justice : WASHINGTON - Thursday, Attorney General Eric Holder and U. S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius kicked off the second in a series of daylong summits bringing together a wide array of federal, state and local partners, beneficiaries...

Ballard Spahr LLP Alert: Final Regulations Address Summary of Benefits and Coverage

By Edward I. Leeds The Affordable Care Act (ACA) requires group health plans and health insurers to prepare and distribute a brief, uniform summary of benefits and coverage (SBC) that aims to provide individuals with a better understanding of the health coverage offered under an arrangement and a...

Williams Mullen Alert: CMS Issues Proposed Rule on 60-Day Reporting/Repayment Obligation for Overpayments to Medicare Providers

By Marcus C. Hewitt As part of 2010's Affordable Care Act, a new section was added to the Social Security Act (Section 1128J(d)), which requires providers to report and return any overpayments they receive from Medicare or Medicaid within 60 days (see http://www.ssa.gov/OP_Home/ssact/title11/1128J...

High Court Upholds Constitutionality of Health Care Act,' Reversing Federal District Court Rulings

By the LexisNexis Jury Verdicts and Settlements Team On Thursday, June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the individual mandate set out in the "ObamaCare" health insurance reform bill, more properly known as the Patient Protection And Affordable Care Act (ACA...

Cadwalader Client & Friends Memo: A 'Hat Trick' of Heightened False Claims Act Risks for Health Care Providers

Introduction At the risk of stating the obvious, fighting and prosecuting health care fraud are top priorities for the Federal Government, and the False Claims Act ("FCA") is its weapon of choice in the battle. In a speech in June, Stuart Delery, the Acting Assistant Attorney General for...

Williams Mullen Alert: Health Care Reform Outlook

By Brydon M. DeWitt and Michael J. Ferrell With the Supreme Court's landmark decision upholding the Affordable Care Act, employers have a renewed interest in what the Act will mean for their businesses in the years ahead. Employers need to be aware of the possible political outcome as they continue...

State Net Capitol Journal: Can California Rescue the Affordable Care Act?

While national candidates wage a war of words and half-truths on health issues, a handful of states, led by California, are charging ahead to implement the key feature of the Affordable Care Act (ACA), widely viewed as the signal achievement of Barack Obama's presidency. The feature is an on-line...

State Net Capitol Journal: States Look to Answer 'Essential' Health Question

Although 35 of the 50 states have yet to create the marketplaces known as health benefits exchanges required by the Affordable Care Act, they aren't completely ignoring the law's impending requirements. A majority, in fact, are moving forward on another key component of federal health reform...

State Net Capitol Journal: Substantial Progress on Affordable Care Act Health Plan Benchmarks

The Affordable Care Act requires states to provide a minimum package of services called "essential health benefits" (EHBs), and the Department of Health and Human Services is allowing each state to model its EHB plan after an existing small group health insurance plan, state employee health...

State Net Capitol Journal: Obama Election Win Leaves GOP Governors Scrambling on Affordable Care Act

For most of the last year, a handful of Republican governors have refused to take action on implementing the Affordable Care Act, preferring instead to bank on the Supreme Court or the November presidential election to send the law to the legislative junk heap. But with all such options now exhausted...

State Net Capitol Journal: Health Care Reform Law Doesn't Halt Major Rate Hikes

One of the main objectives of the Affordable Care Act was to stem the rising cost of health insurance for American consumers. But that hasn't stopped health insurance companies from seeking and obtaining big premium increases across the country. In Florida and Ohio, insurers have secured rate increases...

State Net Capitol Journal: States Have Key Role In Making Affordable Care Act Work

By Lou Cannon , State Net Capitol Journal Winston Churchill famously described a crucial British military victory in North Africa during World War II as "not the end...not even the beginning of the end" but "perhaps, the end of the beginning." For the Affordable Care Act (ACA...

Sands Anderson PC: The Affordable Care Act: What Employers Need to Do Now to Plan for 2014

By Jessica Rogers Beginning January 1, 2014, most U.S. citizens and legal residents will be required to have qualified health care coverage pursuant to the Affordable Care Act ("Act"). The Act requires employers defined as "large" to offer that coverage for its "full-time"...

State Net Capitol Journal: ACA Could Cost Businesses in Non-Expansion States $1.3 Billion Per Year

The Affordable Care Act requires companies with more than 25 employees to pay a "shared responsibility" fine of $3,000 for each worker who isn't eligible for Medicaid and who receives a federal tax subsidy because their employer doesn't offer them health insurance. The provision was...

State Net Capitol Journal: State and Federal Governments Struggle Over Health Care

By Lou Cannon The Affordable Care Act, the Obama administration's vaunted plan for overhauling the nation's health care system, will cost more, insure fewer people and probably take longer to implement than originally planned. States and the federal government are struggling to meet...

State Net Capitol Journal: Ohio Gov. Kasich Still Pushing Medicaid Expansion

The Ohio Legislature has been out on its summer recess for almost two weeks, but Gov. John Kasich (R) has not given up hope lawmakers will return to Columbus sooner than later to green light his call to expand the Buckeye State's Medicaid rolls. At a pro-expansion rally last week, Kasich reiterated...

State Net Capitol Journal: Changes Challenge ACA Implementation

By Rich Ehisen Faced with growing complaints from employers over the complexity of implementing the Affordable Care Act by next January, the Obama administration on July 2 announced it would postpone for one year enforcement of a provision of the law that requires large employers, those with 50 or...

Norton Rose Fulbright: OIG Releases FY 2014Work Plan Summary

By Frederick Robinson , Megan Fanale Engel , Cori Annapolen Goldberg and Selina Coleman On January 31, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published its Work Plan for fiscal year 2014. The OIG announced that in the upcoming year, it will continue...

DLA Piper Health Care Regulatory and Policy Update -- Week of March 24, 2014

SGR/Legislative Action – On March 11, Senate Finance Committee Chairman Wyden (D-OR) introduced his version of legislation to permanently repeal and replace the sustainable growth rate (SGR), the Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014 (S. 2110). CBO scored the...