News & Analysis as of

Enforcement Actions Patient Protection and Affordable Care Act (PPACA) Health Insurance

Foley & Lardner LLP

CMS Finalizes Rule Change Applying Preponderance of the Evidence Standard to Agent, Broker, and Web-Broker Exchange Agreement...

Foley & Lardner LLP on

In its recently issued Final Rule (CMS-9884-F; 90 FR 27074-01; the Final Rule), the Centers for Medicare and Medicaid Services (CMS) finalized revisions to 45 C.F.R. § 155.220(g)(2) to specify a standard of proof for...more

Amundsen Davis LLC

Court Ruling Hamstrings IRS Enforcement of ACA Employer Mandate

Amundsen Davis LLC on

On April 10, 2025, a federal court in Texas issued an opinion in the case of Faulk Co. v. Becerra that significantly impacts how the Affordable Care Act’s (ACA) employer mandate can be enforced. The ruling effectively...more

Bricker Graydon LLP

What Goes Around Comes Around: White House Signals Increased Transparency in Coverage Enforcement

Bricker Graydon LLP on

On February 25, 2025, the White House issued a new executive order aimed at implementing many of the Administration's previously issued directives to health plans. ...more

Genova Burns LLC

10th Birthday Wishes to the Affordable Care Act’s Employer Mandate

Genova Burns LLC on

The Patient Protection and Affordable Care Act (“ACA”) was signed into law by President Obama on March 23, 2010. ACA affected health insurance coverage, costs and preventive care. It also established the Health Insurance...more

McDermott Will & Schulte

New Illinois Protections Against Patient Medical Debt May Also Help Reduce Hospital Bad Debt

Starting in mid-2024, Illinois hospitals will be required to take a much more active role in limiting consumers’ medical debt by screening all consenting uninsured patients for both public health insurance program coverage...more

McDermott Will & Schulte

The ‘No More Restrictive’ Requirement for NQTLs Under the Proposed MHPAEA Regulations

We previously reported on proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). If adopted in final form, these regulations would vastly complicate compliance by group health plans and health...more

The Volkov Law Group

Bioventus Agrees to Pay $3.6 Million to Settle False Claims Act Violations

The Volkov Law Group on

The False Claims Act is a powerful tool for government prosecutors to use against healthcare providers, and drug and device companies.  The Trump Administration used the False Claims Act to attack the opioid industry and rein...more

Morgan Lewis - ML Benefits

DOL’s ERISA Enforcement Activities Focus on Health Plan Compliance

In recent years, reports have indicated robust, and in some respects increasing, enforcement activities by the US Department of Labor (DOL) related to ERISA. The DOL recently issued its enforcement statistics for fiscal year...more

Skadden, Arps, Slate, Meagher & Flom LLP

Skadden's 2019 Insights: Trump Policy Actions Could Reshape Health Care and Life Sciences Landscape

In 2018, President Donald Trump and numerous executive branch agencies announced proposals that, if implemented, will reshape the landscape for virtually every sector of the health care industry. Many of these proposals are...more

Butler Snow LLP

Pro Te: Solutio Vol. 11 No. 1 – A Reflection on the First Ten Years

Butler Snow LLP on

It’s hard to believe a decade has passed since we delivered our first edition of Pro Te: Solutio to your door. Those years have brought enormous changes in the world and in our industry. Innovation has driven everything we...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

Bass, Berry & Sims PLC on

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Skadden, Arps, Slate, Meagher & Flom LLP

As Congress Struggles With ACA Repeal, Trump Administration Moves Forward With Regulatory Reform

The Trump administration and Republican-led Congress spent substantial time and political capital in 2017 on efforts to repeal and replace the Affordable Care Act (ACA) and enact sweeping Medicaid reform. By the end of the...more

Skadden, Arps, Slate, Meagher & Flom LLP

"DOJ Continues Streak of Successful Merger Challenges With Blocked Aetna-Humana, Anthem-Cigna Deals"

In a continuation of recent Department of Justice (DOJ) successes challenging mergers, the U.S. District Court for the District of Columbia recently enjoined two more proposed mergers brought and litigated under the Obama...more

BCLP

DOL Gives a Peek at Non-quantitative Treatment Limitations

BCLP on

While on this day, most people focus on the heart, we’re going to spend a little time focusing on the head. Under the Mental Health Parity and Addiction Equity Act (MHPAEA), health plans generally cannot impose more stringent...more

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