By Rich Ehisen Faced with growing complaints from employers over the complexity of implementing the Affordable Care Act by next January, the Obama administration on July 2 announced it would postpone for one year enforcement of a provision of the law that requires large employers, those with 50 or more workers, to offer those employees health coverage or face fines. The new deadline is now January 1, 2015. The unexpected...

The Ohio Legislature has been out on its summer recess for almost two weeks, but Gov. John Kasich (R) has not given up hope lawmakers will return to Columbus sooner than later to green light his call to expand the Buckeye State's Medicaid rolls. At a pro-expansion rally last week, Kasich reiterated his message that it is a moral issue, saying Americans "need to beat back this image that when somebody's poor...

Arizona Gov. Jan Brewer (R) scored a huge political victory last week as Grand Canyon State lawmakers finally endorsed her call to greatly expand access to the state's Medicaid program. The expansion, part of the $8.8 billion budget lawmakers also adopted, is expected to provide health care coverage to over 300,000 residents. Brewer is one of a handful of Republican governors who broke ranks with the GOP to endorse...

WASHINGTON, D.C. - (Mealey's) In a unanimous opinion, the U.S. Supreme Court on June 10 affirmed that an arbitrator acted within his powers under the Federal Arbitration Act (FAA) in determining that parties affirmatively "agreed to authorize class arbitration" in a case involving a dispute over a health insurer's reimbursement of physicians' claims ( Oxford Health Plans LLC v. John Ivan Sutter,...

By Lou Cannon The Affordable Care Act, the Obama administration's vaunted plan for overhauling the nation's health care system, will cost more, insure fewer people and probably take longer to implement than originally planned. States and the federal government are struggling to meet the deadlines for creating on-line marketplaces, known as exchanges, in which individuals and families will be able to purchase...

The Affordable Care Act requires companies with more than 25 employees to pay a "shared responsibility" fine of $3,000 for each worker who isn't eligible for Medicaid and who receives a federal tax subsidy because their employer doesn't offer them health insurance. The provision was intended to induce small businesses to provide such insurance. Analysis by Brian Haile of Jackson Hewitt Tax Service...

By Rich Ehisen There has long been friction in the relationship between doctors and other health care providers, with the former ferociously guarding their turf against incursion from the latter. But with the Affordable Care Act soon to bring 33 million new patients into the system, many states are pondering whether it is time to allow nurses, physician assistants, optometrists and even dentists to offer patients services...

By Jessica Rogers Beginning January 1, 2014, most U.S. citizens and legal residents will be required to have qualified health care coverage pursuant to the Affordable Care Act ("Act"). The Act requires employers defined as "large" to offer that coverage for its "full-time" employees or pay a penalty. Employers must act now to determine if they are required to provide that coverage (or...

What happened? In a decision released last week, Wos v. E.M.A. [ enhanced version available to lexis.com subscribers ] , the U.S. Supreme Court invalidated North Carolina's Medicaid subrogation laws because they allowed the state to recover more than the medical expense portion of a Medicaid beneficiary's settlement. The beneficiaries in Wos settled a medical malpractice suit involving injuries to their child...

By Lou Cannon , State Net Capitol Journal Winston Churchill famously described a crucial British military victory in North Africa during World War II as "not the end...not even the beginning of the end" but "perhaps, the end of the beginning." For the Affordable Care Act (ACA) that President Obama is now more than willing to call ObamaCare, the end of the beginning occurred in June when the Supreme...

Iowa Gov. Terry Branstad (R) last week unveiled an alternative to expanding Medicaid in the Hawkeye State. Under federal health care reform, states are given the option of expanding their Medicaid eligibility to cover people living at up to 138 percent of the federal poverty line. In Iowa, that would add about 150,000 new enrollees into the system. But Branstad opposes the expansion. Last week, he instead proposed...

LexisNexis® Presents a Complimentary CLE-Accredited* Webinar: The Patient Protection & Affordable Care Act—An ObamaCare Overview & Outlook for In-House Counsel Sweeping, well-intended, controversial and at times polarizing—President Obama’s Patient Protection & Affordable Care Act is one way of resolving the nation’s under and uninsured population. It survived a challenge that went...

One of the main objectives of the Affordable Care Act was to stem the rising cost of health insurance for American consumers. But that hasn't stopped health insurance companies from seeking and obtaining big premium increases across the country. In Florida and Ohio, insurers have secured rate increases of at least 20 percent for some policy holders, which can add several hundred dollars a month to their bills. And...

WASHINGTON, D.C. - (Mealey's) The U.S. Department of Health and Human Services on Feb. 1 issued a notice of proposed rulemaking on recommended changes to the preventive services policy contained in the Patient Protection and Affordable Care Act (PPACA). ( Proposed rules available. Document #31-130206-022X .) Proposed Rules Regulations contained in the PPACA require that employee health insurance plans...

WASHINGTON, D.C. - (Mealey's) In an in-chambers order, the U.S. Supreme Court on Dec. 26 denied a request for an injunction pending appellate review of a lower court's decision rejecting a preliminary injunction to halt the implementation of a mandate contained in the Patient Protection and Affordable Care Act (PPACA) related to the provision of birth control (Hobby Lobby Stores Inc., et al. v. Kathleen Sebelius...

WASHINGTON, D.C. - U.S. Supreme Court Justice Sonia Sotomayor on Dec. 26 refused to block enforcement of the Patient Protection and Affordable Care Act's mandate that profit-making companies begin providing free birth control for women workers on Jan. 1 ( Hobby Lobby Stores Inc., et al. v. Kathleen Sebelius, Secretary of Health and Human Services, et al. , No. 12A644, U.S Sup.). Ruling on an application for...

WASHINGTON, D.C. - (Mealey's) The U.S. Supreme Court on Nov. 26 revived a Christian university's challenge to the Patient Protection and Affordable Care Act (PPACA) when it ordered the Fourth Circuit U.S. Court of Appeals to review the case in light of the high court's ruling in a similar challenge earlier this year ( Liberty University, et al. v. Timothy Geithner, et al. , No. 11-438, U.S. Sup.). Certiorari...

For most of the last year, a handful of Republican governors have refused to take action on implementing the Affordable Care Act, preferring instead to bank on the Supreme Court or the November presidential election to send the law to the legislative junk heap. But with all such options now exhausted, states must finally - and quickly - decide how they will go about putting the law into effect. Cheryl Smith, a director...

The Affordable Care Act requires states to provide a minimum package of services called "essential health benefits" (EHBs), and the Department of Health and Human Services is allowing each state to model its EHB plan after an existing small group health insurance plan, state employee health benefit plan, federal employee health benefit plan or HMO plan. Twenty-three states have selected such benchmark plans...

Although 35 of the 50 states have yet to create the marketplaces known as health benefits exchanges required by the Affordable Care Act, they aren't completely ignoring the law's impending requirements. A majority, in fact, are moving forward on another key component of federal health reform: defining what will be included in the health coverage plans insurers will offer under the law. According to consulting...

WASHINGTON, D.C. -- The American Center for Law and Justice (ACLJ), a pro-life legal organization that focuses on constitutional law, has filed a second federal lawsuit challenging the Department of Health and Human Services (HHS) mandate that violates the religious beliefs of Illinois business owners. The new lawsuit , filed in the U.S. District Court for the Southern District of Illinois, argues that the HHS mandate...

While national candidates wage a war of words and half-truths on health issues, a handful of states, led by California, are charging ahead to implement the key feature of the Affordable Care Act (ACA), widely viewed as the signal achievement of Barack Obama's presidency. The feature is an on-line state marketplace, known as a health insurance exchange, in which families and individuals will be able to shop for affordable...

by Clifford J. Schoner and Brian M. Pinheiro The U.S. Court of Appeals for the 11th Circuit has upheld a federal district court ruling that a wellness program instituted by Broward County, Florida, does not violate the general prohibition under the Americans with Disabilities Act against non-voluntary medical examinations and inquiries that are not job-related. In Seff v. Broward County Florida , the court determined...

Mark Faccenda On August 13, 2012, the U.S. Government Accountability Office ("GAO") issued a report in which it determined that the Patient Protection and Affordable Care Act's ("PPACA") immediate effect on employer-sponsored healthcare coverage would be minimal. Report GAO-12-768, entitled Estimates of the Effect on the Prevalence of Employer-Sponsored Health Coverage, estimated a two-year...

By Mark Anthony Kadzielski , Kristina Pervi Ayers and Jee-Young Kim The United States Supreme Court's recent decision upholding the Patient Protection and Affordable Care Act underscores the need to deliver and make accessible quality healthcare to patients throughout the United States in an efficient and cost-effective manner. This brings both telemedicine and the credentialing and privileging of telemedicine...