LexisNexis® Legal Newsroom
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’...

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...

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...

ACA Employer Mandates and Potential Liability Issues

The employer mandate provisions of the Affordable Care Act – better known as Obamacare – are among the more controversial parts of the legislation. The mandates were originally scheduled to go into effect in 2014, but after lobbying efforts from various business groups, the mandates’...

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...

Five Good Reasons Why You Shouldn’t Miss WCRI’s 31st Annual Conference

Anyone familiar with the Workers Compensation Research Institute’s 31-year history of providing the data and analysis that industry mavericks rely upon to understand, manage and effect real change have come to expect WCRI conferences to provide the kind of keen insight, new lessons, and key strategies...

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...

ObamaCare: PLEASE! Stop Calling It ‘Insurance’

The crescendo and climax of the Supreme Court's King v. Burwell decision ices the cake in the ongoing controversy swirling around the integrity, legality, and constitutionality of the Affordable Care Act. But controversy about the merits and flaws of the Affordable Care Act continues unabated and...

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...

A Healthier Workforce: The Hot Debate Over Employer Responsibility and Employee Incentives

By Jennifer C. Jordan, Esq., General Counsel, MEDVAL LLC A Medicare set-aside (MSA) is sometimes like an exercise in accident reconstruction. And when the MSA gets ugly, as they frequently do, it is typically because of some factor other than the industrial accident itself. Things like, had the employee...

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...

Suellen Wolfe on King v. Burwell

By Suellen M. Wolfe * The Patient Protection and Affordable Care Act (hereinafter referred to as ACA) [PL 111-148, 124 Stat 119 (Mar 23, 2010)] provides for health care reform law in the United States. The ACA consists of the Affordable Health Care for America Act, the Patient Protection Act, health...

Here’s Why You Shouldn’t Miss the WCRI 32nd Annual Conference

Anyone familiar with the Workers Compensation Research Institute’s 32-year history of providing the data and analysis that industry mavericks rely upon to understand, manage and effect real change have come to expect WCRI conferences to provide the discussion and debate of cutting edge issues and...

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...