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...

Ready for Anything: Adopting a Winning Strategy for ACA Compliance

Ancient tomes often guide modern times. For example, the 2,000-year-old military treatise The Art of War , attributed to the Chinese general-philosopher Sun Tzu, is cited regularly in contemporary political thinking, business tactics and legal strategies. Sun Tzu regarded war as a last resort but...

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...

ACA Birth-Control Mandate Burdens Closely Held Corporations, Supreme Court Says

WASHINGTON, D.C. — (Mealey’s) The Patient Protection and Affordable Care Act (ACA)’s contraceptive mandate substantially burdens closely held religious corporations’ religious rights, a divided U.S. Supreme Court held today ( Burwell, Secretary of Health and Human Services, et...

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...

Obamacare Opinions Galore!

Wow, busy day for Obamacare Tuesday. The big story is that a circuit split developed in the span of a few hours. The gist of the issue is that the Obamacare statute (aka "Affordable Care Act") authorizes the government to subsidize health insurance for individuals who purchase a plan from an...

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...

Foley & Lardner LLP: 7th Circuit Rejects Public-Disclosure Bar in Qui Tam Case

By Eric G. Pearson A cardinal rule of a qui tam action brought under the False Claims Act is that the relator must be the information’s original source. In United States ex rel. Heath v. Wisconsin Bell, Inc. , No. 12-3383 (7th Cir. July 28, 2014) , the Seventh Circuit grappled with this bar...

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...

Trojan Horse -- The ACA's 3.8% Medicare Surtax

Editor’s Note : This EIA is excerpted from chapter 1 of the Matthew Bender publication New York University Review of Employee Benefits and Executive Compensation – 2014 , available on Lexis.com, Lexis Advance, and in print HERE . ... In part, the Affordable Care Act created an entirely...

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’...

Klein and Sharman on King v. Burwell: Silence Will Likely Equal Deference in King v. Burwell

by Elise Klein and Joelle Sharman On November 7, 2014, the U.S. Supreme Court granted certiorari to answer the following question: whether the Internal Revenue Service ("IRS") may promulgate regulations to extend tax-credit subsidies to coverage purchased through Exchanges established by...

ObamaCare: PLEASE! Stop Calling It ‘Insurance’

In the ongoing controversy swirling around the integrity, legality, and constitutionality of the Affordable Care Act, a great deal of attention is directed to tax elements: the scope, magnitude, and extensive reach of taxes funding the law; whether or not required premium payments should or should not...

Employer Mandate Extension Attacked as Unconstitutional

On Friday, the U.S. House of Representatives filed this Complaint, alleging that President Obama's unilateral delay and alteration of the Obamacare employer mandate was unconstitutional . The Patient Protection and Affordable Care Act (aka "Obamacare") includes an "employer mandate...

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...

ACA Employer Mandates and Potential Liability Issues

The employer mandate provisions of the Affordable Care Act – better known as Obamacare – are among the more controversial parts of the legislation. The mandates were originally scheduled to go into effect in 2014, but after lobbying efforts from various business groups, the mandates’...