Category: The Affordable Care Act

Final Rules Published Regarding ACA’s Employer Mandate Provisions

The U.S. Department of Treasury (“Treasury Department”) published the much anticipated final rule implementing the employer shared responsibility (“employer mandate”) provisions under the Affordable Care Act (“ACA”) on February 12, 2014. According to a press release issued by the Treasury Department, the final rule “make[s] a number of commonsense improvements in […]

The U.S. Solicitor General Files Memorandum Opposing Injunction on ACA’s Contraceptive Mandate

On Friday, January 3, 2014, the U.S. Solicitor General filed a memorandum in opposition to the emergency application for an injunction temporarily granted by the U.S. Supreme Court on December 31, 2013. The injunction temporarily enjoined the government from enforcing the contraceptive coverage requirements imposed by the Affordable Care Act (ACA) and its related […]

CMS Proposes Medicare Part D Rule for 2015 Contract Year – Antidepressants and Immunosuppressants Would No Longer Be “Protected Classes”; Antipsychotics May Follow

On January 6, 2014, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule: “Contract Year 2015 Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs” (the “Proposed Rule”).  The Proposed Rule is expected to be published in the Federal Register on […]

Supreme Court to Review ACA’s Contraception Mandate

The U.S. Supreme Court (SCOTUS) agreed to review provisions within the Affordable Care Act (ACA) by granting petitions for writs of certiorari yesterday, November 26, 2013. Specifically, SCOTUS will review the provisions that require large employers to offer insurance coverage for birth control and other reproductive health services. 

President Announces Measure to Extend Existing Health Coverage under ACA

On November 14, 2013, President Obama announced a plan that would enable certain Americans with health coverage to keep their existing coverage for an additional year even if their existing coverage fails to meet the minimum standards established under the Affordable Care Act (“ACA”). 

Update on HHS “Qualified Health Plans” Determination: Grassley Weighs in…

As we reported earlier this week, the U.S. Department of Health & Human Services (“HHS”) recently issued a letter concluding that HHS “does not consider [Qualified Health Plans (QHPs)], other programs related to the Federally-facilitated Marketplace, and other programs under Title I of the Affordable Care Act to be federal […]

HHS: Qualified Health Plans are NOT “Federal Health Care Programs” – Implications for Anti-Kickback, CMP, and Exclusion Analyses

In an October 30, 2013, letter to Representative Jim McDermott (D-WA), U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, stated that HHS “does not consider [Qualified Health Plans (QHPs)], other programs related to the Federally-facilitated Marketplace, and other programs under Title I of the Affordable Care Act to […]

States Continue Medicaid Expansion Debate

As President Obama responds to healthcare.gov’s glitches, many states continue to debate whether to expand the Medicaid program in their respective states. The Supreme Court’s decision on the Affordable Care Act (“ACA”) allows states to opt out of the ACA’s Medicaid expansion provisions. Many states have stated their Medicaid expansion plans definitively; however, not all […]

Online Enrollment Delayed for ACA’s Small Business Marketplace

The Obama Administration announced yesterday, September 26, 2013, that it will be delaying the online enrollment for small business owners in the federally-facilitated health insurance marketplace (“Marketplace”), as provided for under the Affordable Care Act (“ACA”) until November 2013. 

The Countdown to October 1, 2013: HHS Builds Partnerships to Increase Enrollment in the Marketplace

The Secretary of the U.S. Department of Health and Human Services  (HHS), Kathleen Sebelius, recently announced partnerships with pharmacies to increase enrollment in the Health Insurance  Marketplace, which is scheduled to open for enrollment on October 1, 2013. According to the announcement, these pharmacies will “take an active role in outreach and education to […]