LexisNexis® Legal Newsroom
Who is 'Lawfully Present' Under the ACA? - Gary Endelman & Cyrus Mehta

"Many non-citizens will be subject to additional payment to the Internal Revenue Service if they do not maintain “minimum essential healthcare coverage” under the Patient Protection and Affordable Care Act (Affordable Care Act – ACA). This is known as the “individual mandate”...

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...

U.S. Supreme Court Hears Arguments Over ACA Federal Exchange Subsidy Availability

WASHINGTON, D.C. — (Mealey’s) Both sides faced critical questioning from Justice Anthony Kennedy during oral arguments March 4 in the case challenging the availability of subsidies in the Patient Protection and Affordable Care Act (ACA) federal exchange ( David King, et al. v. Sylvia Mathew...

Top Court Cites Hobby Lobby In Vacating, Remanding ACA Accommodation Ruling

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on March 9 vacated a Seventh Circuit U.S. Court of Appeals opinion that denied the University of Notre Dame an injunction in its challenge to the Patient Protection and Affordable Care Act (ACA) accommodation process and remanded the case...

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...

Top Court Vacates ACA Birth Control Ruling, Remands Case

WASHINGTON, D.C. — (Mealey’s) The U.S. Supreme Court on April 27 granted two Catholic groups’ petition for certiorari and vacated a Sixth Circuit U.S. Court of Appeals ruling that the Patient Protection and Affordable Care Act’s contraceptive mandate did not substantially burden...

7th Circuit Rejects Preliminary Injunction In ACA Opt-Out Challenge

CHICAGO — (Mealey’s) Notre Dame is not entitled to a preliminary injunction while it challenges the opt-out provision of the Patient Protection and Affordable Care Act (ACA)’s contraceptive mandate, a divided Seventh Circuit U.S. Court of Appeals held May 19 ( University of Notre Dame...

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...

Top Court Rejects Maine’s Challenge To ACA ‘Maintenance Of Effort’ Rule

WASHINGTON, D.C. — (Mealey’s) The Supreme Court on June 8 denied the State of Maine’s petition challenging mandatory continued Medicaid coverage for older children under the Patient Protection and Affordable Care Act’s maintenance of effort requirements, according to the docket...

High Court Affirms Availability Of Tax Credits In ACA Federal Exchange

WASHINGTON, D.C. — (Mealey’s) The Patient Protection and Affordable Care Act (ACA)’s structure suggests the availability of tax subsidies in the federal exchange, and Congress could not have intended the state insurance market “death spirals” likely to result from barring...

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...

Williams Mullen: Supreme Court Upholds ACA Premium Assistance Nationwide

By: Brydon M. DeWitt This morning [June 25], the Supreme Court ruled that Affordable Care Act (ACA) premium tax credits will remain available to individuals residing in states that did not establish their own health insurance marketplaces. In King v. Burwell , the Supreme Court analyzed ACA statutory...

Keeping Tabs on a Non-Citizen's Eligibility for Health Coverage Under the ACA - Cyrus D. Mehta

"President Obama’s healthcare law, the Affordable Care Act (ACA), is here to stay especially after the law withstood a challenge in King v. Burwell that allows the federal government to provide subsidies to poor and middle class people to buy health insurance on a nationwide basis. Even non...

DLA Piper: Supreme Court Upholds ACA Subsidies

By Anne Pachciarek and Rita M. Patel | On June 25, the US Supreme Court issued a 6-3 opinion in King v. Burwell upholding the Affordable Care Act’s subsidy scheme [ enhanced opinion available to lexis.com subscribers ] [lexis.com subscribers may access Supreme Court briefs for this case ...

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...

Cadwalader: Federal Court Upholds Provider Mandate to Report and Return Medicare and Medicaid Overpayments in 60 Days

Introduction | The Patient Protection and Affordable Care Act (“PPACA”), signed into law on March 23, 2010, included a provision (the “Report and Refund Mandate”), broadly requiring health care providers, suppliers, Part D plans and managed care organizations that were overpaid...

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...

Williams Mullen: The Definition of Identify: The 60-Day Rule

By Ruth Levy & Patrick C. Devine, Jr. | The Patient Protection and Affordable Care Act (“PPACA”) established that any person who receives an overpayment from the Medicare or Medicaid programs and who does not report and return the overpayment within 60 days after it is identified will...

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...

Trends to Watch in Workers’ Compensation Law

At the National Workers’ Compensation & Disability Conference last November, Brad Bleakney, a partner with Bleakney & Troiani, and Lora Northen, a Shareholder with Capehart Scatchard, led a seminar on recent trends in workers’ compensation. The following is a Q&A with Brad and...