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...

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...

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...

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: 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...

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...

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...

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...

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...

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...

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...

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...