On March 30, 2023, the U.S. District Court for the Northern District of Texas issued a final judgment in Braidwood Management Inc. v. Becerra, invalidating a requirement in the Patient Protection and Affordable Care Act (ACA)...more
On November 12, 2020, the Trump administration published its final rule on price transparency (the “Final Rule”) requiring affected entities to publicly release personalized information on out-of-pocket costs as well as...more
On October 22, 2018, in perhaps the most significant guidance resulting from President Trump’s 2017 Executive Order 13813, “Promoting Healthcare Choice and Competition Across the United States” (“2017 Executive Order”), the...more
1/10/2019
/ Affordable Care Act ,
Benefit Plan Sponsors ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Executive Orders ,
Health Insurance ,
HRA ,
IRS ,
Medicare ,
Proposed Regulation ,
Qualified Small Employer Health Reimbursement Plan (QSEHRAs) ,
TRICARE ,
Trump Administration
In an unexpectedly broad ruling issued December 14, 2018, the U.S. District Court for the Northern District of Texas declared the Affordable Care Act (“ACA”) as unconstitutional in its entirety. This decision, if ultimately...more
12/19/2018
/ Affordable Care Act ,
Appointments Clause ,
Benefit Plan Sponsors ,
Biosimilars ,
Constitutional Challenges ,
Corporate Counsel ,
Declaratory Judgments ,
Department of Justice (DOJ) ,
Employer Group Health Plans ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
HRA ,
Individual Mandate ,
Internal Revenue Code (IRC) ,
Kathleen Sebelius ,
Medicaid ,
Medicaid Expansion ,
Pharmaceutical Industry ,
Popular ,
Severability Doctrine ,
Tax Cuts and Jobs Act
On June 19, 2018, the Trump administration finalized a rule that will enable small businesses and self-employed individuals to band together to offer access to large group health plans, which are typically less expensive (but...more
The Trump Administration has published a proposed rule allowing a significant change to the definition of "employer" under ERISA that would enable small businesses and self-employed individuals to band together to create...more
On October 12, 2017, President Donald Trump signed an executive order (the “Order”) designed to “promote healthcare choice and competition across the United States,” which in effect will allow many Americans to sidestep...more
The first 100 days of a new presidential administration serves as a traditional, if somewhat arbitrary, demarcation point. April 29, 2017, serves as the 100th day of the Trump administration, and we now have insight into how...more
On February 15, 2017, the Centers for Medicare & Medicaid Services (“CMS”), at the direction of the Trump administration, released a long-expected proposed rule (“Market Stabilization Proposed Rule”)designed to help stabilize...more
Employers in the health care industry are likely to face significant changes under President-elect Donald J. Trump’s administration and should expect a healthy dose of uncertainty for the next few months. During his campaign,...more
12/7/2016
/ Affordable Care Act ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Health Care Providers ,
Hiring & Firing ,
Non-Discrimination Rules ,
OCR ,
Patient Privacy Rights ,
Trump Administration ,
Unions ,
Vaccinations
Health insurers and group health plan sponsors must closely review the final rule titled “Nondiscrimination in Health Programs and Activities” (“Final Rule”) implementing Section 1557 of the Affordable Care Act (“ACA”) that...more
On March 30, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published its long-awaited final rule (“Final Medicaid Parity Rule” or “Final Rule”) implementing the Paul Wellstone and Pete Domenici Mental Health...more
On March 8, 2016, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule titled “Patient Protection and Affordable Care Act; CMS Notice of Benefit and Payment Parameters for 2017” (“Final Rule”)[1] setting...more
The Advance Notice (“Advance Notice”) of Methodological Changes for Calendar Year (“CY”) 2017 for Medicare Advantage (“MA”) Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter was released by the Centers...more
On December 2, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule titled “Patient Protection and Affordable Care Act; CMS Notice of Benefit and Payment Parameters for 2017” (“Proposed...more
On November 22, 2015, the National Association of Insurance Commissioners (“NAIC”) approved an updated version of its Managed Care Plan Network Adequacy Model Act, now known as the Health Benefit Plan Network Access and...more
On September 8, 2015, the U.S. Department of Health and Human Services (“HHS”) published a proposed rule titled “Nondiscrimination in Health Programs and Activities” (“Proposed Rule”)[1] to implement the nondiscrimination...more
10/15/2015
/ Affordable Care Act ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Discrimination ,
Federally Facilitated Exchanges ,
Health Care Providers ,
Health Insurance Exchanges ,
Healthcare ,
OCR ,
Proposed Regulation ,
Public Comment ,
State Health Insurance Exchanges
On May 26, 2015, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) containing the first proposed revisions to the Medicaid managed care (“MMC”) program’s regulations in more than...more
On April 10, 2015, the Centers for Medicare & Medicaid Services (“CMS”) published in the Federal Register a proposed rule (“Proposed Rule”) implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction...more
5/7/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Employer Group Health Plans ,
Healthcare ,
Managed Care Contracts ,
MCOs ,
Medicaid ,
Medicare ,
Mental Health ,
Mental Health Parity Rule ,
Proposed Regulation
On December 19, 2014, various federal agencies issued proposed regulations (“Proposed Regulations”) to amend the definition of “excepted benefits” to include certain limited wraparound health insurance coverage. “Excepted...more
On November 21, 2014, the Obama administration released two proposed rules affecting health insurance issuers’ offering of private health insurance products both inside and outside of the public insurance exchanges...more
Qualified Health Plans (“QHPs”) and other stakeholders have until October 27, 2014, to comment on CMS’s proposed cost sharing reduction payment reconciliation reporting process. On Friday, September 26, 2014, CMS released...more
On July 22, 2014, the U.S. Court of Appeals for the D.C. Circuit and the U.S. Court of Appeals for the Fourth Circuit issued conflicting opinions on a key aspect of the Affordable Care Act ("ACA"). The cases are Halbig v....more
7/30/2014
/ Affordable Care Act ,
Appeals ,
Barack Obama ,
Employer Mandates ,
En Banc Review ,
Halbig v Burwell ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
King v Burwell ,
SCOTUS ,
Subsidiaries ,
Tax Credits
On May 16, 2014, the Centers for Medicare & Medicaid Services ("CMS") released a final rule titled "Patient Protection and Affordable Care Act; Exchange and Insurance Market Standards for 2015 and Beyond" ("Final Rule")...more
6/9/2014
/ Affordable Care Act ,
CCIIO ,
Centers for Medicare & Medicaid Services (CMS) ,
Employer Mandates ,
Federally Facilitated Exchanges ,
Final Rules ,
Health Insurance Exchanges ,
Healthcare ,
Popular ,
Qualified Health Plans ,
Small Business