Affordable Care Act, Waivers

Employer health plan surcharges pose litigation risks

McAfee & Taft on 6/23/2025

Many employers implement wellness programs into their employee health plan offering. Wellness programs have varying designs but commonly offer premium discounts to participants who are tobacco-free or achieve certain...more

The Trifecta: What to Expect from a Second Trump Administration and a Republican Congress

King & Spalding on 12/11/2024

Republicans have swept the 2024 elections, returning Donald Trump to the White House as the 47th President and flipping the Senate to a Republican majority. Having narrowly maintained control of the House of Representatives,...more

CMS Issues IPPS and LTCH PPS Final Rule for FY 2024

King & Spalding on 8/9/2023

On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more

Federal Government Approves Georgia’s State Relief and Empowerment Waiver

King & Spalding on 11/13/2020

On November 1, 2020, CMS and the Department of the Treasury approved Georgia’s request for a 1332 State Relief and Empowerment waiver (1332 waiver), permitting the state to implement a new healthcare plan to address growing...more

Trump Administration Approves Georgia’s Limited Expansion of Medicaid and Work Requiremen

King & Spalding on 10/23/2020

CMS approved Georgia’s Section 1115 demonstration project to partially expand Medicaid coverage for adults not otherwise eligible for Medicaid coverage with incomes up to 95 percent of the Federal Poverty Line (FPL)—short of...more

A Review of the Affordable Care Act at 10 Years, Part 4: Alternative Payment and Delivery Models

Mintz - Health Care Viewpoints on 4/14/2020

Today's post is the last in our series on the 10-year anniversary of the Affordable Care Act (ACA). While the Congress that passed the ACA recognized that health care delivery reform was necessary, the law included few...more

CMS Releases Tools to Support States’ Medicaid and CHIP Programs During the COVID-19 Outbreak

King & Spalding on 4/1/2020

On March 22, 2020, CMS announced a suite of four new tools intended to help states combat the coronavirus by allowing states to streamline enrollment into long-term care and home-based services and by expediting application...more

IRS to Waive HSA Rule for Coronavirus Coverage

Ogletree, Deakins, Nash, Smoak & Stewart,... on 3/16/2020

High-deductible health plans may now cover testing and treatment for 2019 novel coronavirus (COVID-19) on a first-dollar basis without risking making participants ineligible to participate in health savings accounts (HSAs)....more

South Carolina Receives Approval from CMS to Implement Medicaid Work Requirements

King & Spalding on 12/27/2019

On December 12, 2019, CMS approved South Carolina’s proposal for a demonstration project that would add work, or community engagement, requirements as part of the eligibility determinations for the state’s Medicaid plan. ...more

Georgia Officials Announce Section 1115 Waiver Application to Expand Medicaid Eligibility

King & Spalding on 11/19/2019

On November 4, 2019, Georgia officials announced a proposed Section 1115 demonstration waiver, referred to as the “Georgia Pathways Health Waiver,” to expand Georgia’s Medicaid program eligibility for non-disabled adults. If...more

CMS Releases New Tools to Aid Applicants for State Relief and Empowerment Waivers

King & Spalding on 7/26/2019

On July 15, 2019, CMS released new resources, which are available here, that are intended to support states as they apply for waivers under Section 1332 of the Affordable Care Act. These materials follow guidance issued by...more

2019: What to Expect in Health Care Policy

Baker Donelson on 2/12/2019

Health care issues will remain a central focus in Washington throughout 2019. Having gained control of the House following the 2018 mid-term elections, Democrats now have the ability to block President Trump's legislative...more

Fate of Last-Minute Affordable Care Act Initiatives Uncertain

Baker Donelson on 9/21/2017

This week, the debate over the Affordable Care Act (ACA) gained new momentum in two separate, but connected channels. As the fiscal year (FY) budget reconciliation window enabling expedited passage of an ACA repeal draws to a...more

Healthcare Legislation Outlook and Update

Holland & Knight LLP on 8/3/2017

Below is a summary of recent U.S. Senate action on healthcare legislation and our outlook regarding coming issues and possible actions. Holland & Knight's Healthcare & Life Sciences Team will follow up as developments...more

Senate Releases Repeal and Replace Legislation on ACA: The Better Care Reconciliation Act of 2017

Foley & Lardner LLP on 6/28/2017

After weeks of secrecy, the Senate has released a discussion draft of legislation that is the counterpart of the American Health Care Act (AHCA) previously passed by the House. The Senate legislation, entitled the Better Care...more

The Better Care Reconciliation Act: Similarities to House Health Care Bill, Preserves Parts of ACA

Bass, Berry & Sims PLC on 6/24/2017

On June 22, 2017, Senate Republicans released a draft of the Better Care Reconciliation Act (BCRA), their much-anticipated version of the legislation to "repeal and replace" the Affordable Care Act (ACA). Despite rumors of a...more

The American Health Care Act: What Has Changed and What Is Next

Perkins Coie on 5/12/2017

On May 4, 2017, the U.S. House of Representatives approved the American Health Care Act (AHCA) by a vote of 217 to 213 (with 20 Republicans voting against the bill), sending the AHCA to the Senate. As we have reported in...more

House Takes First Step Towards ACA Repeal; Employers Should Stay the Course for Now

Fisher Phillips on 5/6/2017

The House of Representatives took the first affirmative step towards repeal and replacement of the Affordable Care Act (ACA) today. After a failed attempt to pass legislation earlier this year, the House gathered the needed...more

House of Representatives Passes American Health Care Act – What it Means and Next Steps

Proskauer - Employee Benefits & Executive... on 5/6/2017

Today, the House of Representatives passed the American Health Care Act (the “AHCA”). The AHCA was previously introduced in March but supporters failed to muster sufficient support to bring the legislation to a vote....more

Medicaid Outlook: Policy and Regulatory Change in 2017

Epstein Becker & Green on 2/17/2017

Perspectives on Health Care and Life Sciences - Medicaid has been a vital part of the American health care safety net for more than 50 years. Today, Medicaid, along with the State Children’s Health Insurance Program...more

Medicaid Managed Care Transitions’ Impact On Brain Injury Waiver Populations

Mintz - ML Strategies on 9/9/2016

As of June 2015, 24 states utilize a traumatic or acquired brain injury waiver,1 as provided under section 1915(c) of the Social Security Act, which are designed to help individuals with traumatic brain injury (TBI) live in...more

IRS Proposes Restrictions on Employer Opt-Out Payments for ACA Coverage Waivers

Genova Burns LLC on 7/15/2016

In early July the IRS issued proposed regulations addressing the effect that employer payments to employees who waive employer-sponsored health coverage, known as Opt-Out Payments, have on determining whether an ACA-covered...more

Senate Committee Releases Report on Potential Stark Law Changes, Hearing Scheduled

Mintz - Health Care Viewpoints on 7/8/2016

On June 30, 2016, the Senate Finance Committee’s Republican staff issued a 20-page report discussing comments made by industry stakeholders after a December 2015 round-table on the future of the physician self-referral law,...more

New Guidance Outlines Requirements for State Innovation Waivers

Foley & Lardner LLP on 12/21/2015

New guidance from Centers for Medicare & Medicaid Services (CMS) places the spotlight on the ability of states to seek approval of “State Innovation Waivers” to test new approaches for delivering health insurance reform....more

Washington Healthcare Update

McGuireWoods LLP on 11/25/2015

This Week: Congress tries to put together a tax extender package, which may provide an opportunity for some Affordable Care Act changes... HHS releases final rule on bundled payment for Joint Replacement Comprehensive Care...more

Patient Protection and Affordable Care Act (PPACA) › Waivers

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