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...

LexisNexis Presents Free CLE-Accredited* Webinar: The Patient Protection & Affordable Care Act - An ObamaCare Overview & Outlook for In-House Counsel

LexisNexis® Presents a Complimentary CLE-Accredited* Webinar: The Patient Protection & Affordable Care Act—An ObamaCare Overview & Outlook for In-House Counsel Sweeping, well-intended, controversial and at times polarizing—President Obama’s Patient Protection & Affordable...

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...

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: States Ponder Broadening Health Care Scopes of Practice

By Rich Ehisen There has long been friction in the relationship between doctors and other health care providers, with the former ferociously guarding their turf against incursion from the latter. But with the Affordable Care Act soon to bring 33 million new patients into the system, many states are pondering...

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...

Supreme Court Affirms Decision In Health Care Class Arbitration Dispute

WASHINGTON, D.C. - (Mealey's) In a unanimous opinion, the U.S. Supreme Court on June 10 affirmed that an arbitrator acted within his powers under the Federal Arbitration Act (FAA) in determining that parties affirmatively "agreed to authorize class arbitration" in a case involving a dispute...

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...

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...

Steptoe & Johnson PLLC: 4th Circuit Rules CON Statute May Discriminate Against Providers

By Gordon H. Copland | A recent decision suggesting that the Virginia Certificate of Need (“CON”) law may be unconstitutional has widespread implications for CON laws around the country, including West Virginia and Kentucky. The surprising decision, by the Court of Appeals for the Fourth...

Supreme Court Justice Halts Birth Control Mandate For Catholic Group

WASHINGTON, D.C. — (Mealey’s) U.S. Supreme Court Justice Sonia Sotomayor on Dec. 31 temporarily blocked the federal government from enforcing the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) against an order of Catholic nuns at the request of the...

Supreme Court Blocks Enforcement Of Birth Control Mandate

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on Jan. 24 enjoined the federal government from enforcing the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) against an order of Catholic nuns pending final disposition of an appeal by the 10th...

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...

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...

Barnes & Thornburg LLP: President Obama Signs Bill Extending Physician Medicare Rates And Delaying ICD-10 And RAC Audits Under The 2-Midnights Rule

By Nita Garg On April 1, President Obama signed the Protecting Access to Medicare Act of 2014. This legislation extends current Medicare physician reimbursement rates and delays implementation of the ICD-10 code for a full year. Previously, hospitals were to be ICD-10 compliant by October 1, 2014;...

DLA Piper Alert: Federal Agencies Propose Health IT Regulatory Framework, Seek Stakeholder Input and Participation In New Initiatives

By Mary B. Langowski and Kristen E. Ratcliff A little more than five years after the passage of the Health Information Technology Economic and Clinical Health (HITECH) Act, the Food and Drug Administration, Federal Communications Commission and the Office of the National Coordinator for Health IT have...

Foley & Lardner LLP: Hospitals Urging SCOTUS to Limit False Claims Act Penalties

What do a moving company and a hospital association have in common? The False Claims Act (FCA). The American Hospital Association along with the United States Chamber of Commerce and the Pharmaceutical Research and Manufacturers of America recently submitted an amici curiae brief in support of petitioners...

Foley & Lardner LLP: SEC's MCDC Initiative - The Clock is Ticking

By David Y. Bannard Not-for-profit health care providers that have borrowed on a tax-exempt basis within the last five years should be aware of the Securities and Exchange Commission’s (SEC) Municipalities Continuing Disclosure Cooperation (“MCDC”) Initiative. The MCDC Initiative...

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...