State Net Capitol Journal: The Obamacare Pitfall: Health Care Issues Dominate State Politics

By Lou Cannon Obamacare remains an untidy work in progress in the states, which are struggling with Medicaid expansion, website problems, and insurance issues in an election year in which health care policy issues are overshadowed by partisan politics. Tim Storey, a political analyst with the National...

State Net Capitol Journal: A Tale of 2 Obamacares

The starkly contrasting ways in which Democrat- and Republican-led states have generally responded to the Affordable Care Act is creating two separate health care systems, according to a report released last week by the Obama administration. Democrat-leaning Kentucky, which has warmly embraced the ACA...

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: Employer Healthcare Mandate Transition Relief Announced

By Brydon M. DeWitt This week, the Treasury Department announced transition rules that delay implementation of the Affordable Care Act (ACA) employer health insurance mandate for some employers and modify it for others. The ACA requires employers with at least 50 full-time employees to offer affordable...

Ballard Spahr LLP: ACA Employer Mandate Final Regulations Released; Enforcement Delays Provided for Mid-Sized Employers

By Brian M. Pinheiro, Jean C. Hemphill and Jonathan M. Calpas | Very large employers will be required to offer health care coverage to their full-time employees or pay a penalty to the federal government beginning January 1, 2015. Under the final regulations released by the U.S. Department of Treasury...

Obamacare Architect Estimates Three-Year Delay in Accurately Understanding Affordable Care Act Impact on Workers’ Compensation

The statement of economist Jonathan Gruber, Ph.D. , of the Massachusetts Institute of Technology in Cambridge, Massachusetts that a three-year news blackout regarding the Affordable Care Act (ACA) would have had merit was arguably the most memorable moment during the 2014 Annual Issues and Research Conference...

Marsh Report on ACA and Workers’ Compensation: Helping Employers to Keep a Foothold on Snowy Roads and Black Ice

Karen C. Yotis, Esq., a Feature Resident Columnist for the LexisNexis Workers’ Compensation eNewsletter , provides insights into workplace issues and the nuts and bolts of the workers’ comp world. Whatever your views happen to be about the Patient Protection and Affordable Care Act of...

Hurricane Obamacare: Experts Attempt to Forecast Impact of Affordable Care Act on Workers’ Compensation

Workers’ Compensation Research Institute (WCRI) Executive Director Richard Victor, Ph.D. of Cambridge, Massachusetts stated in his presentation “Impact of the Affordable Care Act on Workers’ Compensation” during WCRI’s 2014 Annual Issues and Research Conference on March...

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...

The ACA's Impact on LPRs Residing Outside the USA: Endelman & Mehta

"[U]nless the IRS provides more specific guidance, it is not clear at this time whether an LPR who takes the bona fide residence exception for purposes of shielding foreign income can also be deemed to have the minimum essential coverage. LPRs who seek to claim a section 911 type foreign earned...

Oregon Officials Abandon State Insurance Exchange, Turn To Federal Exchange

DURHAM, Ore. — (Mealey’s) Oregon on April 25 dumped its failed Patient Protection and Affordable Care Act (ACA) state exchange at an agency board meeting, with the governing body unanimously adopting a technology workgroup suggestion that the federal exchange provided the most reliable and...

Affordable Care Act: A New Body of Law With Lots of Moving Parts

Practical Guidance on Administering ObamaCare and Other Health Plans The acronym “ACA” has now joined the acronym “ADA” in the panoply of regulations with which companies must comply. As with any new and unfamiliar system, some companies may be uncertain as to what exactly...

Williams Mullen: New COBRA and CHIP Notices Highlight Affordable Care Act Marketplaces

B y Brydon M. DeWitt The Department of Labor recently issued updated model COBRA continuation coverage and Childrens’ Health Insurance Program (“CHIP”) notices. Plan administrators should begin using the new notices immediately. The revised model COBRA notices address the availability...

Foley & Lardner LLP: It's Not a Federal Question: 7th Circuit Sends Case Involving Affordable Care Act Funds Back to State Court

What is or what is not a federal question under Grable & Sons Metal Products, Inc. v. Darue Engineering & Manufacturing , 545 U.S. 308 (2005) [ enhanced opinion available to lexis.com subscribers ], is an issue that continues to perplex lawyers, judges, and law students alike. In Hartland Lakeside...

D.C. Circuit Strikes Down Subsidies For Federal Exchanges

WASHINGTON, D.C. — (Mealey’s) Patient Protection and Affordable Care Act (ACA) premium tax credits are available only for individuals who enrolled through state exchanges and not the federal exchange, a District of Columbia U.S. Circuit Court of Appeals panel majority held July 22. The dissent...

Ballard Spahr LLP: IRS Issues Draft ACA Reporting Forms

By Jonathan M. Calpas and Edward I. Leeds The Internal Revenue Service recently released draft versions of the forms that will be used to meet the shared responsibility reporting requirements under the Affordable Care Act (ACA). These draft forms have been released for comment and may not be used...

ACA Compliance: Getting Ahead of the Curve. A LexisNexis® White Paper with Cynthia Stamer

The looming implementation of another round of employer mandates under the Affordable Care Act (ACA) has business leaders scrambling for help from legal counsel and other advisors. This flurry of activity is prudent; compliance with ACA is a matter of federal law and many penalties for failure to comply...

Ballard Spahr LLP: Government Agencies Release Further Accommodations to Organizations Opposing Mandated Contraceptive Coverage

By Jean Hemphill and Brian Pinheiro In response to the recent U.S. Supreme Court decision in Burwell v. Hobby Lobby, Inc., [ enhanced opinion available to lexis.com subscribers ], the U.S. Departments of Health and Human Services (HHS) and Labor (DOL) published proposed rules on August 22, 2014, expanding...

Full D.C. Appeals Court Takes Up ACA Tax Credit Case

WASHINGTON, D.C. — (Mealey’s) The District of Columbia Circuit U.S. Court of Appeals granted en banc review on Sept. 4 of a decision finding that the Patient Protection and Affordable Care Act (ACA) provides tax credits only for individuals who enrolled through state-created exchanges ( Jacqueline...

State Net Capitol Journal: California Ponders Health Insurance Rate Regulation

By Rich Ehisen | Note: On Nov. 4, 46 states will hold legislative elections, while 36 will elect or retain a governor. Meanwhile, 41 states will also weigh in on a wide range of ballot measures addressing some of the most controversial issues of the year, including abortion, marijuana use and the...

Government Tells High Court ACA Language Supports Broad Tax Subsidy Availability

WASHINGTON, D.C. — (Mealey’s) No conflict among courts exists regarding the availability of tax credits for individuals obtaining insurance through federal exchanges, an outcome supported by the language and structure of the Patient Protection and Affordable Care Act (ACA), the government...

Ballard Spahr LLP: Student Employees Under The Affordable Care Act's Employer Mandate

By Edward I. Leeds and Daniel V. Johns Effective January 1, 2015, colleges and universities will need to comply with the employer mandate under the Affordable Care Act, which will have particular implications involving certain student employees. The employer mandate requires large employers (defined...

2014 Workers’ Compensation Emerging Issues

The new edition of Workers’ Compensation Emerging Issues Analysis (LexisNexis) is a veritable cornucopia of expert analysis, provocative commentary, and a 50 state survey of workers’ compensation legislation in 2014 As with last year’s inaugural edition, the 2014 Larson Series Workers’...

DLA Piper: Binding Arbitration in Managed Care Contracts - 6 Tips to Tailor Your Dispute Resolution Provisions

By Stephen L. Goff and John Barnes The Affordable Care Act is moving millions of previously uninsured patients into commercial managed care health plans. As the healthcare system grapples with complexity of this shift, the size of disputes between healthcare providers and managed care payers, in terms...

DLA Piper: Government Turns Up the Heat With the False Claims Act – 5 Action Steps for Healthcare Providers

By Savaria B. Harris and Mitka T. Baker Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations. Just last month, the Health...