Mealey's Health Law - U.S. House Extends Grandfathering Of Insurance For Small Businesses

WASHINGTON, D.C. - The U.S. House of Representatives on Sept. 11 passed legislation grandfathering more insurance plans from compliance with the Patient Protection and Affordable Care Act (ACA) minimum coverage standards

Mealey's Health Law - Court Halts Briefing After Government Moves For Remand In Birth Control Case

DETROIT - The Sixth Circuit U.S. Court of Appeals on Sept.12 held briefing of a Patient Protection and Affordable Care Act (ACA) contraceptive mandate challenge in abeyance until resolution of the government's unopposed motion to remand (Mersino Management Co., et al. v. Sylvia Burwell, et al., No...

Mealey's Health Law - HHS Expands Primary Care Access With $295 Million In ACA Funds

WASHINGTON, D.C. - More than $295 million in Patient Protection and Affordable Care Act (ACA) funds have been awarded in an effort to help health centers expand access to primary care services, according to a Sept. 12 release by the U.S. Department of Health and Human Services (HHS).

Mealey's Health Law - ACA Changes Allow Renewal Of Black Lung Cases, 11th Circuit Holds

ATLANTA - The Patient Protection and Affordable Care Act (ACA)'s elimination of the causation requirement in Black Lung benefits cases permits pursuit of a denied claim originally made final in 2006, an 11th Circuit U.S. Court of Appeals panel held Sept. 12 (Jim Walter Resources Inc. v. Director...

Mealey's Health Law - Federal Claims In Prescription Drug Case Dismissed; Remaining Claims Remanded

BIRMINGHAM, Ala. - A federal judge in Alabama on Sept. 10 dismissed antitrust, Racketeer Influenced and Corrupt Organization Act and unjust enrichment claims against the third-party administrator of prescription medication and remanded the remaining state law claims to state court (Star Discount Pharmacy...

Mealey's Health Law - Appeals Court Affirms Judgment In Favor Of Insurer In Denial Of Benefits Suit

PHOENIX - In an unpublished opinion, an Arizona appeals panel on Sept. 11 affirmed summary judgment in favor of a health insurance company in a wrongful denial of health care benefits suit (Nicolai Tavilla, et al. v. Blue Cross and Blue Shield of Arizona Inc., No. CV-12-0843, Ariz. App., Div. 1; 2014...

Mealey's Health Law - California Judge Allows Limited Discovery In Denial Of Health Benefits Suit

SAN DIEGO - A federal judge in California on Sept. 12 granted a plaintiff's motion for limited discovery beyond the administrative record in his wrongful denial of benefits case (Christopher Brown v. United Healthcare Insurance Co., et al., No. 14-661, S.D. Calif.; 2014 U.S. Dist. LEXIS 128219).

Mealey's Health Law - Plaintiffs In Reimbursement MDL Oppose Dismissal Of Complaint, Support Amendment

NEWARK, N.J. - Plaintiffs involved in an antitrust and racketeering multidistrict litigation case accusing Aetna Inc. of underpaying out-of-network reimbursement claims asked a New Jersey federal court on Sept. 12 to deny the defendant's motion to dismiss the suit, which Aetna had filed just two...

Mealey's Health Law - Health Insurers Ask Pradaxa MDL Judge To Vacate His 'Amnesty' Order For Liens

EAST ST. LOUIS, Ill. - Fifteen health insurers on Sept. 15 asked an Illinois federal judge to dissolve or vacate his order ordering private lien holders to notify plaintiffs' counsel of their claims or risk having them foreclosed (In Re: Pradaxa [Dabigatran Etexilate] Products Liability Litigation...

Mealey's Health Law - 6th Circuit Denies Rehearing After Refusing To Enjoin Birth Control Mandate

GRAND RAPIDS, Mich. - The Sixth Circuit U.S. Court of Appeals on Sept. 16 denied en banc rehearing in a pair of cases challenging the Patient Protection and Affordable Care Act (ACA) contraceptive mandate opt-out, leaving stand a June decision affirming denial of injunctive relief (Michigan Catholic...

Mealey's Health Law - Physician Group Defends Standing In ACA Tax Case From Seemingly Skeptical Panel

MILWAUKEE - A cash-only physicians group challenging the Internal Revenue Service's implementation of the Patient Protection and Affordable Care Act (ACA) faced repeated questioning during Sept. 16 oral arguments from a Seventh Circuit U.S. Court of Appeals panel seemingly skeptical of its standing...

Mealey's Health Law - 7th Circuit Finds Lack Of Standing, Nixes ACA Tax Challenge

MILWAUKEE - The administration's decision to delay implementation of the Patient Protection and Affordable Care Act (ACA) employer mandate does not provide a cash-only physicians group with standing, a Seventh Circuit U.S. Court of Appeals panel held Sept. 19 (Association of American Physicians &...

Mealey's Health Law - District Of Columbia Federal Judge Dismisses Medicare Billing Suit

WASHINGTON, D.C. - A District of Washington federal judge on Sept. 17 dismissed a suit challenging limits to the billings of certain Medicare claims, saying the court lacked jurisdiction (The American Hospital Association, et al. v. Sylvia Matthews Burwell, No. 12-1770, D. D.C.; 2014 U.S. Dist. LEXIS...

Mealey's Health Law - Calif. Appeals Court Affirms Enforcement Of Billing Law Is Not A New Regulation

SACRAMENTO, Calif. - In an unpublished opinion, a California appeals panel on Sept. 18 affirmed that the California Department of Health Services' decision to begin enforcing a law requiring health providers to follow rigid billing procedures for Medi-Cal reimbursement claims or risk forfeiture is...

Mealey's Health Law - La. Federal Judge Affirms Decision Declining To Remand Balance Billing Suit

MONROE, La. - A Louisiana federal judge on Sept. 18 affirmed a magistrate judge's decision denying a motion to remand a class action dispute over balance billing, agreeing that a local exception rule did not apply (Bruce Stewart, et al. v. Ruston Louisiana Hospital Co., et al., No. 14-83, W.D. La...

Steptoe & Johnson PLLC: CMS Final IPPS Rule Effective Oct. 1, 2014

By Jami K. Suver, Of Counsel In August 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final inpatient prospective payment system (IPPS) rule for fiscal year 2015, applicable to inpatient stays at general acute care and long-term care hospitals (LTCH). The rule applies to discharges...

DLA Piper: Bankruptcy Sales for Distressed Hospitals: 4 Questions to Ask Before You Begin

By Thomas R. Califano , Rachel Nanes and Daniel G. Egan Over the last several years, a wide range of healthcare companies, among them hospitals, home health agencies and continuing care facilities, have faced financial distress as a result of declining revenues, high operating costs, reduction in...

Mealey's Health Law - ACA Exchanges Will Feature 77 New Issuers, HHS Says

WASHINGTON, D.C. - Patient Protection and Affordable Care Act (ACA) exchanges will feature 77 new insurance issuers in 2015, a 25 percent increase from the previous year, the U.S. Department of Health and Human Services said Sept. 23.

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...

DLA Piper Health Systems Alert: BYOD: Cool But Dangerous – 3 HIPAA Security Rule Challenges, 7 Key Precautions

By Peter F. McLaughlin From reliable surveys and less dependable anecdotes, opinions point to the almost inevitable expansion of BYOD – bring your own device – as a cost-saving model for employers. Advisors assure company decision makers that direct savings will flow by avoiding the...

Mealey's Health Law - Government Asks Judge To Stay Judgment Motion In ACA Challenge Case

WASHINGTON, D.C. - A District of Columbia federal judge should stay consideration of a summary judgment motion until resolution of jurisdictional questions in a case challenging the government's delayed implementation of portions of the Patient Protection and Affordable Care Act (ACA), the government...

Mealey's Health Law - Government Says Affordable Care Act Reducing Uncompensated Hospital Care

WASHINGTON, D.C. - The Patient Protection and Affordable Care Act (ACA) will save hospitals $5.7 billion in uncompensated care, according to a U.S. Department of Health and Human Services report issued Sept. 24.

Mealey's Health Law - Government To 11th Circuit: ACA Challengers Seek To Convert 'Shield Into A Sword'

MONTGOMERY, Ala. - The 11th Circuit U.S. Court of Appeals should reject plaintiffs' attempt to transform religious protections from a "shield into a sword" in a challenge to the Patient Protection and Affordable Care Act (ACA) contraceptive mandate, the government argued in a Sept. 26 brief...

Mealey's Health Law - Judge Allows Evidence Of Noneconomic Damages In Denial Of Benefits Trial

TRENTON, N.J. - In an unpublished opinion, a federal judge in New Jersey on Sept. 24 granted a plaintiff's motion in limine, which will allow her to introduce evidence of noneconomic damages at trial in her case alleging that a health insurer was negligent when it delayed approval of health benefits...

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...