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Category Archives: Affordable Care Act (ACA)

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Countdown to Compliance for Section 1557 of the Patient Protection and Affordable Care Act

Posted in Affordable Care Act (ACA), Compliance Issues
If you are an entity covered by Section 1557 of the Patient Protection and Affordable Care Act (Section 1557), you have less than a week to prepare your non-discrimination notices and taglines. The final rule implementing 1557 requires that by October 16, 2016, healthcare providers and other covered entities publish and disseminate non-discrimination notices, including… Continue Reading

CMS Issues New Proposed Rule to Modernize Managed Care for Medicaid

Posted in Affordable Care Act (ACA), Guest Contributor, Legislation, Medicaid, Regulations
The Centers for Medicare and Medicaid Services (“CMS”) has issued a new proposed rule (the “Proposed Rule”) intended to “modernize Medicaid and the Children’s Health Insurance Program (CHIP) managed care regulations to update the programs’ rules and strengthen the delivery of quality care for beneficiaries.” As CMS continues it mission toward creating better care, smarter… Continue Reading

CMS Launches Next Generation ACO

Posted in Accountable Care Organizations, Affordable Care Act (ACA)
The Centers for Medicare and Medicaid Services (“CMS”) has released information about a new accountable care organization (“ACO”) model, called the Next Generation ACO. According to CMS, “the Next Generation ACO Model offers a new opportunity in accountable care – one that sets more predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate… Continue Reading

News from the Health Law Gurus™: Week of February 22, 2015

Posted in Affordable Care Act (ACA), EHR, Fraud and Abuse, HIPAA, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Meaningful Use Attestation Deadline Extended to March 20, 2015 – According to a news alert from the Centers for… Continue Reading

OIG Report Outlines Five Recommendations for Hospice Care Reform

Posted in Affordable Care Act (ACA), Medicare
The Patient Protection and Affordable Care Act requires the Centers for Medicare and Medicaid Services (“CMS”) to reform the hospice payment system, collect data relevant to revising hospice payments and develop quality measures for hospices. In a recently released report, the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) made several… Continue Reading

News from the Health Law Gurus™: Week of February 1, 2015

Posted in Affordable Care Act (ACA), HIPAA, Legislation, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Millions Affected by Hackers’ Attack on Health Insurer Anthem, Inc. – “Anthem was the target of a very sophisticated… Continue Reading

News from the Health Law Gurus™: Week of January 11, 2015

Posted in Affordable Care Act (ACA), Business Associates, Covered Entities, HIPAA, Legislation, Privacy, Uncategorized
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Top Five Resolutions for Covered Entities and Business Associates in 2015 – The New Year is here. It is… Continue Reading

CMS Issues Proposed Rule Addressing Changes to Medicare Shared Savings Program

Posted in Affordable Care Act (ACA), Regulations
The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule (the “Proposed Rule”) on December 1, 2014 regarding certain changes to the Medicare Shared Savings Program (the “Program”). The Proposed Rule, spanning 429 pages, discusses proposed changes to various aspects of the Program such as beneficiary assignment, data sharing, available risk models, eligibility… Continue Reading

News from the Health Law Gurus™: Week of November 9, 2014

Posted in Affordable Care Act (ACA), HIPAA, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. HIPAA in the Time of Ebola – Ebola has recently been the source of much concern, and health care… Continue Reading

CMS Announces Launch of Open Payments Database: $3.5 Billion Paid to Physicians and Teaching Hospitals

Posted in Affordable Care Act (ACA), Anti-Kickback Statute, Fraud and Abuse, Trends
The Open Payments database (the “Database”) is now live, and the first round of data is available to the public on the Centers for Medicare and Medicaid Services (“CMS”) website. This first round of data reflects “nearly 4.4 million payments valued at nearly $3.5 billion attributable to 546,000 individual physicians and almost 1,360 teaching hospitals,”… Continue Reading

News from the Health Law Gurus™: Week of August 24, 2014

Posted in Affordable Care Act (ACA), Anti-Kickback Statute, Medicare, News from the Health Law Gurus, OIG Advisory Opinion, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. CMS Bolsters Roster Before Next Health Insurance Marketplace Open Enrollment Period – The Department of Health and Human Services… Continue Reading

News from the Health Law Gurus™: Week of August 17, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, False Claims Act, Fraud and Abuse, Health Insurance, HIPAA, News from the Health Law Gurus, Stark Law
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Chinese Hackers Infiltrate Health System Network Affecting 4.5 Million Individuals – Community Health Systems, Inc. (“CHS”) reported this week… Continue Reading

News from the Health Law Gurus™: Week of August 3, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, Fraud and Abuse, News from the Health Law Gurus, Technology, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. ICD-10 Compliance Deadline Is Now October 1, 2015 – Health care providers, health plans, and health care clearinghouses (“Health… Continue Reading

News from the Health Law Gurus™: Week of July 20th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, News from the Health Law Gurus, Privacy
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Circuit Split on ACA Subsidies—On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court… Continue Reading

A Tale of Two Circuits: D.C. Circuit, Fourth Circuit Split on ACA Subsidies

Posted in Affordable Care Act (ACA), Individual Mandate
It was the best of times for ACA subsidies, it was the worst of times for ACA subsidies. On Tuesday, the Court of Appeals for the D.C. Circuit (“D.C. Circuit”) and the Court of Appeals for the Fourth Circuit (“Fourth Circuit”) came to different conclusions as to the legality of Affordable Care Act (“ACA”) subsidies… Continue Reading

News from the Health Law Gurus™: Week of July 13th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, Legislation, News from the Health Law Gurus
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. $1 Million Settlement Reached in $73 Million Overbilling FCA Suit—Florida-based Halifax Health (“Halifax”) has settled a False Claims Act… Continue Reading

News from the Health Law Gurus™: Week of June 22nd, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, Health Insurance, HIPAA, News from the Health Law Gurus, Privacy, Regulations
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every week for the latest health law news stories. Pa. Supreme Court Weighs in on Medical Record Charges—In Wayne M. Chiurazzi Law v. MRO, Chief Justice Ronald D.… Continue Reading

News from the Health Law Gurus™: Week of June 15th, 2014

Posted in Affordable Care Act (ACA), Health Insurance, Technology, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every Friday for the latest health law news stories. AMA Releases Policy on Telemedicine—Last week, the American Medical Association (“AMA”) released a policy on the provision of telemedicine… Continue Reading

News from the Health Law Gurus™: Week of May 4th, 2014

Posted in Affordable Care Act (ACA), Compliance Issues, HIPAA, Privacy
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every Friday for the latest health law news stories. Massachusetts to Start from Scratch with Health Insurance Website—Massachusetts plans to abandon its health insurance exchange website in favor… Continue Reading

COBRA Coverage Too Expensive? Consider ACA Coverage Instead, Obama Administration Says

Posted in Affordable Care Act (ACA), Health Insurance
On Friday, the Obama administration announced a proposed rule (the “Proposed Rule”) that will require that notices sent to workers regarding Consolidated Omnibus Budget Reconciliation Act (“COBRA”) health insurance coverage must also include information on purchasing health insurance through the health insurance exchange created as part of the Affordable Care Act (“ACA”). Generally, COBRA coverage allows… Continue Reading

News from the Health Law Gurus™: Week of April 27th, 2014

Posted in Affordable Care Act (ACA), False Claims Act, Fraud and Abuse, News from the Health Law Gurus, Technology, Trends
News from the Health Law Gurus™ is a weekly summary of notable health law news from around the country with helpful links to related content. Check back every Friday for the latest health law news stories. FSMB Provides Guidance for State Medical Boards on Use of Telemedicine Technology—The Federation of State Medical Boards (“FSMB”) released… Continue Reading

It’s Not Too Late: You May Still Qualify for ACA Coverage

Posted in Affordable Care Act (ACA), Health Insurance, Individual Mandate
March 31 was the last day to enroll in a health insurance plan through the federally-facilitated health care exchange. However, like many other Affordable Care Act (“ACA”) deadlines, the March deadline was a soft deadline, as certain consumers may receive additional time to enroll in a health insurance plan. The Centers for Medicare and Medicaid… Continue Reading

March 31: ACA Deadline or Just Another Monday?

Posted in Affordable Care Act (ACA), Health Insurance, Individual Mandate
March 31, 2014 is the open enrollment deadline for individuals who want to buy health insurance through the Health Insurance Marketplace (also known as the “Exchange”).  Or is it? The Wall Street Journal is reporting that the Obama Administration might extend for certain individuals the March 31, 2014 deadline to enroll in Affordable Care Act… Continue Reading

HHS to Health Insurers: Same Treatment for Same-Sex Couples

Posted in Affordable Care Act (ACA), Health Insurance
A release and a blog post from the Department of Health and Human Services (“HHS”) on Friday announced that starting in 2015, health insurance companies will be required to offer coverage to same-sex spouses if they offer coverage for opposite-sex spouses. The release, in the form of Frequently Asked Questions (“FAQs”), clarified certain regulations implementing… Continue Reading