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

August 29, 2014 | By Lawrence J. Tabas

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 and the Centers for Medicare and Medicaid Services (“CMS”) have announced the addition of two new individuals to their team in anticipation of the next Health Insurance Marketplace open enrollment period, which begins this fall, to obtain health insurance coverage in 2015. According to the press release, Kevin Counihan and Lori Lodes, have been hired to help ensure successful enrollment. Mr. Counihan has been named the Marketplace CEO and Ms. Lodes is the new Director of Communications for CMS. Mr. Counihan previously served as the CEO for Connecticut’s successful Health Insurance Exchange and Ms. Lodes was the Senior Vice President for Campaigns and Strategies for the Center for American Progress Action Fund and the Center for American Progress. To read the full announcement, click here.

Arrangement for Discounts between Hospital and Insurer Will Not Trigger AKS Penalties, According to OIG – In a recently released Advisory Opinion 14-07, the Office of Inspector General (“OIG”) analyzed a proposed arrangement involving discounts between a licensed offeror of Medigap policies (“Insurer”) and a preferred hospital organization with hospitals throughout the county (“Hospitals”). According to the Advisory Opinion, the arrangement is structured so that the Hospitals will discount Medicare inpatient deductibles for the insurer’s policyholders and the Insurer will share the savings with its policyholders as $100 premium credits. The OIG determined that the arrangement could potentially violate the Anti-Kickback Statute; however, in this instance, the OIG determined that it would not impose sanctions. To read the full Advisory Opinion, click here.

2019 Medicare Budget Reduced by $95 Billion – The New York Times is reporting that the projected Medicare budget for 2019 is $95 billion less than the projected budget for 2019 four years ago. According to the article, “[t]he country still faces a projected deficit in future decades, thanks mostly to the retirement of the baby boomers and the high cost of medical care, but it is not likely to require the level of fiscal pain that many assumed several years ago.” To read the full New York Times article, click here.

About the Authors

Lawrence J. Tabas


Lawrence is the Chair for Obermayer’s Health Care Law Department and Election Law Practice Group. Lawrence’s Health Care Law legal experience includes the representation of Pennsylvania County governments in Behavioral Health Managed...

Read More by Author