LexisNexis® Legal Newsroom
4th Circuit Finds ACA Tax Credit Proper Under IRS Interpretation

RICHMOND, Va. — (Mealey’s) Patient Protection and Affordable Care Act (ACA) language governing whether individuals who enroll through the federal exchange are entitled to tax credits is ambiguous enough to defer to the Internal Revenue Service’s interpretation, a Fourth Circuit U.S...

D.C. Circuit Rejects ‘Origination Clause’ Attack On ACA Individual Mandate

WASHINGTON, D.C. — (Mealey’s) A plaintiff challenging the individual mandate of the Patient Protection and Affordable Care Act (ACA) cannot do so by arguing that the requirement is a revenue measure that should have originated in the U.S. House of Representatives, a unanimous federal appeals...

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...

Judge Finds Indiana, School District Employers Allege Injury Under ACA

INDIANAPOLIS — (Mealey’s) A state and 39 school districts challenging the legality of payments imposed on large employers under the Internal Revenue Services’ implementation and interpretation of Patient Protection and Affordable Care Act (ACA) regulations allege an addressable injury...

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...

HHS Issues Alteration To ACA Contraceptive Mandate Accommodation Rule

WASHINGTON, D.C. — (Mealey’s) Eligible employers opposed to Patient Protection and Affordable Care Act (ACA) provisions mandating insurance coverage for contraceptives may notify the U.S. Department of Health and Human Services (HHS), which will in turn notify the employer’s insurer...

Study Finds States With Expanded Medicaid Experiencing Bump In ER Volume

GREENWOOD VILLAGE, Colo. — (Mealey’s) States with expanded Medicaid under the Patient Protection and Affordable Care Act (ACA) saw a threefold increase in emergency-department visits over nonexpansion states in the second quarter of 2014, according to a Sept. 8 study. (This story is an...

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...

DLA Piper: Healthcare Industry Compliance In A Shifting World: Putting It All Together

By: Frank E. Sheeder , Karen Nelson and Keri L. Tonn Health industry clients face regulatory and enforcement challenges on multiple fronts. It can be difficult to prioritize and allocate resources properly when government agencies’ initiatives are constantly shifting. The first, fundamental...

U.S. High Court Agrees To Decide Availability Of Subsidies In State Insurance Exchanges

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on Nov. 7 agreed to decide whether the Patient Protection and Affordable Care Act (ACA) authorizes tax subsidies for individuals who enroll in insurance through state exchanges ( David King, et al. v. Sylvia Mathew Burwell, et al. , No...

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...

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...

State Net Capitol Journal: States Leave Partisan Fold On Health Care And The Minimum Wage

By Lou Cannon As the nation's capital resumes its customary political gridlock, both political parties are turning to the states to advance national agendas. In the process of doing so, however, they are finding that they are far from united within their own ranks. Republicans in Washington want...

U.S. Supreme Court Hears Arguments Over ACA Federal Exchange Subsidy Availability

WASHINGTON, D.C. — (Mealey’s) Both sides faced critical questioning from Justice Anthony Kennedy during oral arguments March 4 in the case challenging the availability of subsidies in the Patient Protection and Affordable Care Act (ACA) federal exchange ( David King, et al. v. Sylvia Mathew...

Top Court Cites Hobby Lobby In Vacating, Remanding ACA Accommodation Ruling

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on March 9 vacated a Seventh Circuit U.S. Court of Appeals opinion that denied the University of Notre Dame an injunction in its challenge to the Patient Protection and Affordable Care Act (ACA) accommodation process and remanded the case...

Top Court Vacates ACA Birth Control Ruling, Remands Case

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on April 27 granted two Catholic groups’ petition for certiorari and vacated a Sixth Circuit U.S. Court of Appeals ruling that the Patient Protection and Affordable Care Act’s contraceptive mandate did not substantially burden...

7th Circuit Rejects Preliminary Injunction In ACA Opt-Out Challenge

CHICAGO — (Mealey’s) Notre Dame is not entitled to a preliminary injunction while it challenges the opt-out provision of the Patient Protection and Affordable Care Act (ACA)’s contraceptive mandate, a divided Seventh Circuit U.S. Court of Appeals held May 19 ( University of Notre Dame...

Ballard Spahr LLP: New Guidance on Affordable Care Act Reporting Requirements

By Edward I. Leeds The Internal Revenue Service has issued two lengthy sets of questions and answers on the requirement under the Affordable Care Act that employers report on their compliance with the employer mandate and employees' qualification for exchange subsidies. The new guidance is divided...

Top Court Rejects Maine’s Challenge To ACA ‘Maintenance Of Effort’ Rule

WASHINGTON, D.C. — (Mealey’s) The Supreme Court on June 8 denied the State of Maine’s petition challenging mandatory continued Medicaid coverage for older children under the Patient Protection and Affordable Care Act’s maintenance of effort requirements, according to the docket...

High Court Affirms Availability Of Tax Credits In ACA Federal Exchange

WASHINGTON, D.C. — (Mealey’s) The Patient Protection and Affordable Care Act (ACA)’s structure suggests the availability of tax subsidies in the federal exchange, and Congress could not have intended the state insurance market “death spirals” likely to result from barring...

Williams Mullen: Supreme Court Upholds ACA Premium Assistance Nationwide

By: Brydon M. DeWitt This morning [June 25], the Supreme Court ruled that Affordable Care Act (ACA) premium tax credits will remain available to individuals residing in states that did not establish their own health insurance marketplaces. In King v. Burwell , the Supreme Court analyzed ACA statutory...

DLA Piper: Supreme Court Upholds ACA Subsidies

By Anne Pachciarek and Rita M. Patel | On June 25, the US Supreme Court issued a 6-3 opinion in King v. Burwell upholding the Affordable Care Act’s subsidy scheme [ enhanced opinion available to lexis.com subscribers ] [lexis.com subscribers may access Supreme Court briefs for this case ...