LexisNexis® Legal Newsroom
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...

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...

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...

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...

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...

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...

2014 Workers’ Compensation Emerging Issues

The new edition of Workers’ Compensation Emerging Issues Analysis (LexisNexis) is a veritable cornucopia of expert analysis, provocative commentary, and a 50 state survey of workers’ compensation legislation in 2014 As with last year’s inaugural edition, the 2014 Larson Series Workers’...

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...

State Net Capitol Journal: States Leave Partisan Fold On Health Care And The Minimum Wage

By Lou Cannon As the nation's capital resumes its customary political gridlock, both political parties are turning to the states to advance national agendas. In the process of doing so, however, they are finding that they are far from united within their own ranks. Republicans in Washington want...

Workers’ Compensation and Its Secondary Payers: Medicare and Medicaid

Last November I had the pleasure of participating in a panel with two more eminently qualified folks—Jennifer C. Jordan of MEDVAL, LLC and Tim Nay at Nay & Friedenberg —about Medicare Secondary Payer (MSP) compliance at the 23rd Annual National Workers’ Compensation and Disability...

Truth and Consequences of the Affordable Care Act: Shifting of Patient Treatment From General Healthcare to Workers’ Compensation

By Ryan Benharris, Esq. The Impact of the Affordable Care Act on National Workers’ Compensation was the leadoff session at the 2015 Workers Compensation Research Institute (WCRI) Annual Convention. “Resilience or Renovation,” was the overall theme of this year’s event, which...

Ballard Spahr LLP: New Guidance on Affordable Care Act Reporting Requirements

By Edward I. Leeds The Internal Revenue Service has issued two lengthy sets of questions and answers on the requirement under the Affordable Care Act that employers report on their compliance with the employer mandate and employees' qualification for exchange subsidies. The new guidance is divided...

A Vote for Status Quo: The Supreme Court Upholds ACA Subsidies

by Iris Tilley On June 25, 2015, the Supreme Court ruled to uphold the government’s interpretation of Affordable Care Act (“ACA”) subsidies. The Court’s 6-3 opinion leaves the status quo in place, so while it adds one piece of much-needed clarity to the ACA’s unwieldy...

Affordable Care Act: How It Can Reduce Workers’ Compensation Costs and Provide Better Outcomes for Injured Workers

By Ryan Benharris, Esq. The Patient Protection and Affordable Care Act (ACA) and the unpredictability on its future effect on workers’ compensation systems across the country continue to be a hot topic among workers’ compensation scholars. Last month, the William Mitchell Law Review...

DLA Piper LLP: Federal Court Sides With Government In First Interpretation Of ACA’s 60-day False Claims Act Rule

By Adam J. Rogers , Bradley M. Smyer and Karen Nelson | In a significant development for healthcare providers, a federal court in New York has adopted the government’s interpretation of the 2010 Patient Protection and Affordable Care Act’s (ACA’s) so-called 60-day rule, which governs...

Barnes & Thornburg: DOJ Secures Big Win in First Court Interpretation of FCA’s 60-Day Overpayment Rule

By Jessica Talati On August 3, Judge Edgardo Ramos of the Southern District of New York denied hospital defendants’ motions to dismiss in United States ex rel. Kane v. Healthfirst, Inc., et al . , No. 11 CIV 2325 (S.D.N.Y. Aug. 3, 2015), keeping alive a much-followed whistleblower case accusing...

Barnes & Thornburg LLP: Recent Rulings May Spell Trouble for the ACA

By Anne Compton-Brown | President Obama’s signature healthcare legislation will likely force two more significant legal hurdles after decisions this month that attack peripheral but important portions of the Affordable Care Act (ACA). On Sept. 17, 2015, the United States Court of Appeals...

Affordable Care Act Case-Shifting Incentives May Result in Increased Medical Costs for Workers’ Compensation

As incentives within the Patient Protection and Affordable Care Act (ACA) push more and more patients toward so-called “capitated” health insurance plans—in which payments are “prospectively” made to health care providers at the beginning of the plan year on a per capita...

Keller and Heckman LLP: Debate Over NYC Sodium Menu Labeling Gets Salty

On Sept. 9, 2015, the New York City Board of Health unanimously passed regulations making New York the first U.S. city to require restaurants to disclose to diners those menu items that contain more than 2,300 milligrams of sodium, or the equivalent of about one teaspoon of salt. Under the newly-adopted...

News Excerpts From the July 1, 2016, Bender’s Immigration Bulletin

Colorado Repeals Employment Verification Requirement | On June 8, 2016, Colorado Gov. John Hickenlooper signed a bill (House Bill 16-1114) repealing a state requirement that employers maintain a separate affirmation form and retain copies of documents presented when newly hired employees complete...

Does the Affordable Care Act Push Medical Expenses Toward Workers' Comp Insurers?

Recent JAMA Study Indirectly Supports Earlier WCRI Findings Since President Obama signed the Affordable Care Act (ACA) into law on March 23, 2010, there has been a debate within the workers’ compensation (WC) world as to whether one of the ACA’s unintended consequences is to promote cost...