News & Analysis as of

Health Insurance Exchanges Medicare Centers for Medicare & Medicaid Services (CMS)

Health Insurance Exchanges are government-regulated private health insurance markets where individuals can purchase standardized health insurance plans.
Greenbaum, Rowe, Smith & Davis LLP

One Big Beautiful Bill Act: An Overview of Key Healthcare Provisions & Impacts

The One Big Beautiful Bill Act (OBBBA) was signed into law on July 4, 2025. A sweeping piece of legislation that reshapes healthcare financing and delivery across Medicaid, Medicare, and the insurance marketplaces, the bill...more

Sheppard Mullin Richter & Hampton LLP

Health and Human Services Exchange Program Integrity Final Rule

On December 20, 2019, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on program integrity for Affordable Care Act (ACA) exchange plans. This rule implements a number of provisions from the ACA,...more

King & Spalding

Health Plan Responsibility to Pay for Hospital Inpatient Care When Members Await Placement at Post-Acute Facilities

King & Spalding on

Hospitals that attempt to discharge a patient to a post-acute level of care but are not able to because they cannot find an appropriate accepting facility must continue providing care if the patient cannot be safely...more

Carlton Fields

The Affordable Care Act: On the Fast Track to Repeal

Carlton Fields on

On January 20, hours after his inauguration, President Donald Trump issued an executive order directing the heads of all executive departments and agencies to “waive, defer, grant exemptions from, or delay the implementation...more

Alston & Bird

Health Care Advisory: Highlights of the OIG’s 2016 Work Plan

Alston & Bird on

On November 2, 2015, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) issued its Work Plan for Fiscal Year 2016 (“2016 Work Plan”).1 The 2016 Work Plan outlines the areas of...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

Elections for Speaker of the House and Potential Changes at Ways and Means Committee - Rep. Paul Ryan (R-WI) announced Tuesday (Oct. 20) that he will run for the House Speaker position if the major House Republican...more

McGuireWoods LLP

Washington Healthcare Update

McGuireWoods LLP on

Bicameral Bill Introduced to Provide HHS Authority to Reject Proposed Insurance Rates - Before Congress left for its Columbus Day recess, Rep. Jan Schakowsky (D-IL) and Sen. Diane Feinstein (D-CA) introduced the Health...more

Faegre Drinker Biddle & Reath LLP

A First Step on a Long Road: CMS Begins Implementation of ACA Transparency Standards

On August 11, 2015, the Centers for Medicare and Medicaid Services (CMS) posted for public comment notice of a new required data collection for health insurers. Its purpose is to begin the implementation of section 1311 of...more

Mintz - ML Strategies

Health Care Update - July 2015 #3

Mintz - ML Strategies on

ACA Repeal Votes Continue: As part of a rare Senate Sunday session to consider a bill to replenish the highway trust fund for six years, Majority Leader Mitch McConnell (R-KY) brought up an amendment to repeal the ACA—in...more

Mintz - ML Strategies

Health Care Update - July 2015

Mintz - ML Strategies on

In This Issue: - Medicare Releases Set of Payment Rules, Physician Fee Schedule on Deck - Implementation of the Affordable Care Act - Federal Regulatory Initiatives - Congressional Initiatives - Other...more

Mintz - ML Strategies

Health Care Update - March 2015

Mintz - ML Strategies on

In This Issue: - King v. Burwell before the Supreme Court and the Potential Congressional Response - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Congressional...more

Cozen O'Connor

Health Care Reform Implementation Update - May 2014

Cozen O'Connor on

Congress held several hearings last week ranging from Sylvia Burwell’s nomination for Secretary of the Department of Health and Human Services (HHS), to Medicare payment oversight, to post-acute care in Medicare. The Centers...more

Mintz - Health Care Viewpoints

Health Care Update

In This Issue: - Implementation of the Affordable Care Act - Other Federal Regulatory Initiatives - Other Congressional and State Initiatives - Other Health Care News - Upcoming Hearings and Markups -...more

Baker Donelson

The Year to Come for General Counsel: Payment Reform, Managed Care and Affiliations - Part 1: Payment Reform Four Years After the...

Baker Donelson on

Part one of a three-part series - As the public begins to navigate the health insurance exchanges and healthcare.gov cleans up its glitches, executive leadership of most health systems, hospitals and physician...more

Cozen O'Connor

Health Care Reform Implementation Update - December 19, 2013

Cozen O'Connor on

The deadline to enroll in coverage for January 1 was officially extended by a week, but the new December 23 deadline is fast approaching, and premium payments are required to be paid by the last day of 2013 for January 2014...more

Polsinelli

Health Reform + Related Health Policy News - December 2013

Polsinelli on

In This Issue: - Top News ..CMS Releases Payment Rules for the Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System, Renal Dialysis and Home Health ..President Signs the Drug Quality...more

Mintz - Health Care Viewpoints

Health Care Reform Update -- November 25, 2013

In This Issue: Implementation of the Affordable Care Act; Other HHS and Federal Regulatory Initiatives; Other Congressional and State Initiatives; and Hearings and Mark-Ups Scheduled. Excerpt from...more

King & Spalding

Ordering/Referring Provider Edits To Be Turned On Effective January 6, 2014

King & Spalding on

On November 6, 2013, CMS announced that it plans to turn on claims processing edits (effective January 6, 2014) to deny Part B clinical laboratory and imaging, and DMEPOS, and Part A home health agency claims that fail...more

Polsinelli

Health Reform + Related Health Policy News - October 2013

Polsinelli on

In This Issue: - Top News ..Judge Orders $237.4 Million Penalty Against Tuomey for Stark Law and False Claims Act Violations ..Glitches and Demand Lead to Marketplace Frustration ..HHS Delays Small...more

King & Spalding

CMS Issues Final Program Integrity Rule for Affordable Insurance Exchanges

King & Spalding on

On August 30, 2013, CMS published a final rule establishing certain program integrity requirements for the private health insurance marketplaces—called Affordable Insurance Exchanges (or Health Insurance...more

Cozen O'Connor

Health Care Reform Implementation Update - August 26, 2013

Cozen O'Connor on

In response to security concerns about personal information in the health insurance exchanges, the Centers for Medicare and Medicaid Services (CMS) released a new security agreement for the data hubs where this information...more

Carlton Fields

Regulations Affect Health Insurance Exchange Navigators, Mortgage Servicers

Carlton Fields on

At both the federal and state levels, 2013 is proving to be a year of significant activity and regulatory changes for the insurance industry. Originally Published in TortSource - Summer 2013....more

King & Spalding

CMS Releases 2014 OPPS/ASC Proposed Rule

King & Spalding on

On July 8, 2013, CMS released the annual Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule for calendar year 2014 (the “Proposed Rule”). Significant proposed changes include...more

Cozen O'Connor

Health Care Reform Implementation Update - July 16, 2013

Cozen O'Connor on

Capitol Hill and the agencies went back and forth last week on the impact and consideration involved in delaying the Affordable Care Act’s (ACA) employer mandate; votes in the House are expected this week on it, as well as a...more

Cozen O'Connor

Health Care Reform Implementation Update - June 27, 2013

Cozen O'Connor on

The countdown is on now. Less than 100 days until the Affordable Care Act’s (ACA) main provisions go into effect, and Organizing for Action and Enroll America kicked outreach efforts to the uninsured into high gear last week....more

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