Why should Estate Planning and Special Needs Attorneys be concerned about the new Patient Protection and Affordable Care Act? That question is answered by Certified Elder Law Attorney Andrew Hook, CELA, CFP®, of Oast & Hook, P.C., the past president of the Special Needs Alliance. Hook discusses...
WASHINGTON, D.C. - (Mealey's) States challenging the Patient Protection and Affordable Care Act (PPACA) filed a petition on Sept. 28 for writ of certiorari with the U.S. Supreme Court, saying an 11th Circuit U.S. Court of Appeals decision affirming that the individual mandate contained in the act...
WASHINGTON, D.C. -- The federal government on Sept. 28 filed a petition for writ of certiorari with the U.S. Supreme Court, saying the 11th Circuit U.S. Court of Appeals erred in affirming that the individual mandate contained in the Patient Protection and Affordable Care Act (PPACA) is unconstitutional...
By Marcus C. Hewitt As part of 2010's Affordable Care Act, a new section was added to the Social Security Act (Section 1128J(d)), which requires providers to report and return any overpayments they receive from Medicare or Medicaid within 60 days (see http://www.ssa.gov/OP_Home/ssact/title11/1128J...
WASHINGTON, D.C. - (Mealey's) In a sweeping opinion covering four issues addressed over three days of oral argument, the U.S. Supreme Court on June 28 found that the Anti-Injunction Act (AIA) does not bar challenges to the Patient Protection and Affordable Care Act (PPACA), that the individual mandate...
By Elise Klein and Joseph Hegedus In one of the most anticipated opinions of its term and perhaps in over half a century, the United States Supreme Court today resolved constitutional challenges to two provisions of the Patient Protection and Affordable Care Act (the "ACA"): First, a surprising...
The Supreme Court issued its long-awaited opinion on "Obamacare" (aka Patient Protection and Affordable Care Act): National Federation of Independent Business, et al. v. Sebelius (opinion here) [ enhanced version available to lexis.com subscribers ]. It's a 193-page monster, but here's...
By Stephanie A. Kennan , Brian Looser , Vincent A. Dongarra and R. Brent Rawlings Intro: On June 28, 2012, the Supreme Court of the United States issued its opinion in the case of National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al. [ enhanced...
On Thursday, June 28, the United States Supreme Court issued its highly anticipated decision on the constitutionality of portions of the Affordable Care Act (ACA) ( Nat. Fed'n of Indep. Bus. v. Sebelius , together with Florida v. Dept. of HHS and Dept. of HHS v. Florida ) [ enhanced version available...
Introduction At the risk of stating the obvious, fighting and prosecuting health care fraud are top priorities for the Federal Government, and the False Claims Act ("FCA") is its weapon of choice in the battle. In a speech in June, Stuart Delery, the Acting Assistant Attorney General for...
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...
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...
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...
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...
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...
By Frederick Robinson , Megan Fanale Engel , Cori Annapolen Goldberg and Selina Coleman On January 31, 2014, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published its Work Plan for fiscal year 2014. The OIG announced that in the upcoming year, it will continue...
By Marcus C. Hewitt H.H.S’s Office of Inspector General’s yearly work plan was issued on January 31, 2014, which included numerous new and ongoing reviews and activities by OIG for the coming year. Among the new projects, OIG will review Medicare payments to hospitals for outpatient evaluation...
By Gayland Hethcoat With the release of its work plan for fiscal year 2014 on Jan. 31, 2013, the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has provided insight on the agency’s current enforcement priorities in Medicare, Medicaid, and other HHS programs...
By: Benjamin Koplin , Selina Coleman and R. Jeffrey Layne The Centers for Medicare & Medicaid Services (CMS) has posted new resources to its "Open Payments" website to clarify its recently announced two-stage approach to registration and data submission. These resources include: ...
The United States Attorney for the Southern District of West Virginia has announced a record $4.675 million settlement with a medical lab for false billings to Medicare and to West Virginia Medicaid. R. Booth Goodwin, of Charleston, WV, said in his press release that Calloway Laboratories of Woburn,...
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...
By: Karen Nelson Much has been written about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and its repeal of the Sustainable Growth Rate formula for physician compensation and the potential gainsharing safe harbor. But the Act also includes certain Medicare program integrity provisions...
By Judith A. Waltz The Department of Health and Human Services (HHS) Office of Inspector General (HHS-OIG) has released its Fiscal Year (FY) 2014 Annual Report (Report) on the performance of the Medicaid Fraud Control Units (MFCUs) (OEI-06-15-00010, April 2015). Although the MFCUs reported another...
By Anil Shankar and Adam J. Hepworth The Centers for Medicare and Medicaid Services (“CMS”) released, on May 26, 2015, the a far-ranging proposal for revising the Medicaid managed care regulations (“ Proposed Rule ”). The number of individuals enrolled in Medicaid managed care...