The Class Act: Long-Term Care Planning as a Result of the Community Living Assistance Services and Support Act, by Kevin Bress

As part of the Health Reform Bill signed into law by President Obama, Title VIII of the Patient Protection and Affordable Care Act establishes a government-run long-term care insurance program to be funded by payroll deductions from employees. Dubbed the "Class Act" this program becomes effective...

Massachusetts Take-Away Messages for National Health Care Reform

By Regina Rockefeller, Partner, Nixon Peabody Ongoing health care reform discussions in Washington focus on subsidies to help low- and moderate-income Americans buy insurance on new health insurance exchanges, an expansion of Medicaid to cover the poor, incentives to encourage small businesses to...

Podcast - Changes to Medicare and Medicaid by the Patient Protection and Affordable Care Act, with Mary Alice Jackson, Bradley Frigon and Stuart Zimring

On this edition, Mary Alice Jackson, Bradley Frigon and Stuart Zimring discuss how the new law changes Part D coverage and how Medicare premiums are determined, tax issues created by the act such as the new Medicare tax on individuals and Medicaid issues including how the act expands the number of people...

Medicare Set-Asides and Special Needs Trusts

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL LLC Now that those involved in personal injury settlements, whether workers’ compensation or liability insurance based, have finally come to understand the Medicare Secondary Payer Act (“MSP”) to some extent, it appears that...

Podcast: Special Needs Planning and Trusts and the Impact of the PPACA Health Care Reform Act

Why should Estate Planning and Special Needs Attorneys be concerned about the new Patient Protection and Affordable Care Act? That question is answered by Certified Elder Law Attorney Andrew Hook, CELA, CFP®, of Oast & Hook, P.C., the past president of the Special Needs Alliance. Hook discusses...

States Challenging Health Care Act Petition High Court For Expedited Review

WASHINGTON, D.C. - (Mealey's) States challenging the Patient Protection and Affordable Care Act (PPACA) filed a petition on Sept. 28 for writ of certiorari with the U.S. Supreme Court, saying an 11th Circuit U.S. Court of Appeals decision affirming that the individual mandate contained in the act...

Federal Government Petitions Supreme Court, Files Response In Health Care Act Cases

WASHINGTON, D.C. -- The federal government on Sept. 28 filed a petition for writ of certiorari with the U.S. Supreme Court, saying the 11th Circuit U.S. Court of Appeals erred in affirming that the individual mandate contained in the Patient Protection and Affordable Care Act (PPACA) is unconstitutional...

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...

Supreme Court Finds Individual Mandate In Health Care Act Constitutional

WASHINGTON, D.C. - (Mealey's) In a sweeping opinion covering four issues addressed over three days of oral argument, the U.S. Supreme Court on June 28 found that the Anti-Injunction Act (AIA) does not bar challenges to the Patient Protection and Affordable Care Act (PPACA), that the individual mandate...

Breakdown of the Supreme Court Ruling on Patient Protection and Affordable Care Act

By Elise Klein and Joseph Hegedus In one of the most anticipated opinions of its term and perhaps in over half a century, the United States Supreme Court today resolved constitutional challenges to two provisions of the Patient Protection and Affordable Care Act (the "ACA"): First, a surprising...

SCOTUS Obamacare Ruling In (Mostly) Plain English

The Supreme Court issued its long-awaited opinion on "Obamacare" (aka Patient Protection and Affordable Care Act): National Federation of Independent Business, et al. v. Sebelius (opinion here) [ enhanced version available to lexis.com subscribers ]. It's a 193-page monster, but here's...

McGuireWoods on the Supreme Court's Federal Health Care Reform Law Decision

By Stephanie A. Kennan , Brian Looser , Vincent A. Dongarra and R. Brent Rawlings Intro: On June 28, 2012, the Supreme Court of the United States issued its opinion in the case of National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al. [ enhanced...

DLA Piper - Health Care at the Crossroads: The Supreme Court's Decision on the Affordable Care Act

On Thursday, June 28, the United States Supreme Court issued its highly anticipated decision on the constitutionality of portions of the Affordable Care Act (ACA) ( Nat. Fed'n of Indep. Bus. v. Sebelius , together with Florida v. Dept. of HHS and Dept. of HHS v. Florida ) [ enhanced version available...

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...

State Net Capitol Journal: Iowa Governor Issues Alternative to Medicaid Expansion

Iowa Gov. Terry Branstad (R) last week unveiled an alternative to expanding Medicaid in the Hawkeye State. Under federal health care reform, states are given the option of expanding their Medicaid eligibility to cover people living at up to 138 percent of the federal poverty line. In Iowa, that would...

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...

Steptoe & Johnson PLLC: U.S. Supreme Court Limits State Medicaid Recoveries to Medical Expenses

What happened? In a decision released last week, Wos v. E.M.A. [ enhanced version available to lexis.com subscribers ] , the U.S. Supreme Court invalidated North Carolina's Medicaid subrogation laws because they allowed the state to recover more than the medical expense portion of a Medicaid beneficiary's...

State Net Capitol Journal: Brewer Wins Medicaid Battle With Her Own Party

Arizona Gov. Jan Brewer (R) scored a huge political victory last week as Grand Canyon State lawmakers finally endorsed her call to greatly expand access to the state's Medicaid program. The expansion, part of the $8.8 billion budget lawmakers also adopted, is expected to provide health care coverage...

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...

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...

Williams Mullen: OIG Scrutiny of Hospital Outpatient Evaluation/Management Claims Billed to Medicare

By Marcus C. Hewitt H.H.S’s Office of Inspector General’s yearly work plan was issued on January 31, 2014, which included numerous new and ongoing reviews and activities by OIG for the coming year. Among the new projects, OIG will review Medicare payments to hospitals for outpatient evaluation...

Barnes & Thornburg LLP: OIG Work Plan 2014: Takeaways for Hospitals

By Gayland Hethcoat With the release of its work plan for fiscal year 2014 on Jan. 31, 2013, the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has provided insight on the agency’s current enforcement priorities in Medicare, Medicaid, and other HHS programs...

Norton Rose Fulbright: CMS Offers New Resources and Guidance on 2-Phase Approach to Sunshine Act Reporting

By: Benjamin Koplin , Selina Coleman and R. Jeffrey Layne The Centers for Medicare & Medicaid Services (CMS) has posted new resources to its "Open Payments" website to clarify its recently announced two-stage approach to registration and data submission. These resources include: ...

Steptoe & Johnson PLLC: False Billing Leads To Record Settlement In Medicare/Medicaid Fraud Case

The United States Attorney for the Southern District of West Virginia has announced a record $4.675 million settlement with a medical lab for false billings to Medicare and to West Virginia Medicaid. R. Booth Goodwin, of Charleston, WV, said in his press release that Calloway Laboratories of Woburn,...

Norton Rose Fulbright: Physicians Payments Sunshine Act Data 33 Percent Unpublishable, Penalties Next?

By Benjamin Koplin , Selina Coleman and R. Jeffrey Layne Despite extending the dispute-and-resolution deadline to account for the days that the Centers for Medicare & Medicaid Services (CMS) pulled down the reporting system, the public Physician Payments Sunshine Act website is still expected...