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...

Top Court Rejects Religious Groups’ Challenges In Birth Control Cases

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on March 31 denied petitions for certiorari from two nonprofit religious groups claiming that the contraceptive mandate contained in the Patient Protection and Affordable Care Act (ACA) violates the Religious Freedom Restoration Act (RFRA...

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...

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...

Court Hears Arguments In Origination-Clause Challenge To Individual Mandate Tax

WASHINGTON, D.C. — (Mealey’s) A District of Columbia Circuit U.S. Court of Appeals panel on May 8 heard arguments over whether the Patient Protection and Affordable Care Act (ACA)’s individual mandate tax constitutes a revenue measure and should properly have originated in the U.S....

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...

The Hobby Lobby Primer: How A Craft Store Changed The Legal Landscape

Now that the United States Supreme Court has issued its decision in Burwell v. Hobby Lobby Stores, Inc. , 2014 U.S. LEXIS 4505 (U.S. June 30, 2014) , many are left with questions on the breadth of the decision and what it means going forwards. Below is a brief primer . [lexis.com subscribers may access...

11th Circuit Cites Hobby Lobby, Enjoins Mandate During Appeal

MONTGOMERY, Ala. — (Mealey’s) A Catholic media outlet is entitled to an injunction while it appeals rejection of its Patient Protection and Affordable Care Act (ACA)’s contraceptive mandate challenge in light of Burwell v. Hobby Lobby (Nos. 13-354, 13-356, U.S. Sup. [lexis.com subscribers...

HHS Urges Top Court Not To Grant Emergency Injunction During ACA Appeal

WASHINGTON, D.C. — (Mealey’s) The Supreme Court should deny a nonprofit Christian liberal arts college’s request for an emergency injunction of the Patient Protection and Affordable Care Act (ACA) contraceptive mandate while it appeals an adverse ruling, the government said July 2 in...

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...

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...

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...

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...

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...

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...

Norton Rose Fulbright: CMS Offers Settlement Of Inpatient RAC Denials

By Mark Faccenda On August 29, 2014, the Centers for Medicare and Medicaid Services (“ CMS ”) announced that certain providers with pending appeals of specified inpatient-status claims denied by Medicare contractors may elect to receive partial payment on those claims in exchange for the...