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...

Pregunte a Lambda Legal - El Acto de Cuidado Económico y VIH

Por Scott Schoettes, director del Proyecto VIH de Lambda Legal Recientemente me hice la prueba del VIH y salí positivo. Un amigo me dijo que si cambio de trabajo puede que sea difícil mantener el seguro médico. ¿Qué tipo de seguro hay para mí? Hoy en día...

Ask Lambda Legal - The Affordable Care Act and HIV

By Scott Schoettes, HIV Project Director for Lambda Legal Q: I recently tested positive for HIV, and a friend told me that I might have a hard time keeping health insurance if I changed jobs. What kind of insurance is available for me? A: In 2012, a positive HIV test result is the beginning of...

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...

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...

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...

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: 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: 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...

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...

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...

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...