News & Analysis as of

Health Insurance Data Collection

Jones Day

Medicare's Innovation Center Charts New Direction: Part 3 – Drugs, Devices, and Data

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The Center for Medicare and Medicaid Innovation ("CMMI") is set to reshape value-based care. In the third of a three-part series highlighting this new direction, this summary is focused on CMMI's efforts regarding drugs,...more

Polsinelli

Kansas Insurance Department Issues Data Call to All Third Party Administrators Licensed in Kansas

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The Kansas Insurance Department (“Department”) recently issued a Data Call to all Third Party Administrators (“TPAs”) licensed in the state of Kansas. Pursuant to the Data Call, the Department has requested information...more

Verrill

RxDC Reporting in Light of June 1, 2024 Deadline and Recent PBM Litigation

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Under the Consolidated Appropriations Act of 2021 (“CAA”), employer-sponsored group health plans, including medical-only plans, must submit information about their prescription drugs and health care spending. This submission...more

Woodruff Sawyer

Agencies Release Revised Instructions for 2022 Reference Year RxDC Reporting

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On March 3, 2023, federal agencies released revised Prescription Drug Data Collection (RxDC) Reporting Instructions applicable to the 2022 reference year. RxDC reporting for the 2022 reference year is due on or before June 1,...more

Goodwin

Biden Executive Order Calls for Heightened Antitrust Scrutiny

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On July 9, 2021, President Joe Biden announced a broad executive order (the “Order”) intended to boost what it characterizes as stagnant competition across the U.S. economy. The Order, among other things, encourages the...more

Cozen O'Connor

Democratic Attorneys General Support DOL’s Fight For Narrower Definition Of ERISA Health Plans

Cozen O'Connor on

A group of 22 Democratic AGs, led by District of Columbia AG Karl Racine, filed an amicus brief in the U.S. Court of Appeals for the Fifth Circuit in S. Department of Labor v. Data Marketing Partnership, No. 20-11179, in...more

Hogan Lovells

Coronavirus: The Hill and the Headlines – COVID-19 D.C. Update – July 2020 #9

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In Washington: Senate Majority Leader Mitch McConnell (R-KY) on Monday told reporters that when the Senate returns next week Republicans will start discussions on the next coronavirus stimulus package with their Democratic...more

FordHarrison

What Impact Could Trump's Election Have on Employers?

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The election is over. The vote is in. Donald Trump will be our 45th President. And, for the first time since 2006 (when the 109th Congress was in session during the Bush administration), come 2017, a Republican President will...more

Poyner Spruill LLP

"They Can't Do That To Our Pledges; Only We Can Do That To Our Pledges”: Admiral, Big Data, Privacy, and The Internet of Things

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Anyone who has ever bought insurance, resented the premium, contested a claim denial, or piled up hours and papers dealing with insurers would welcome anything that promised to lower their rates. Admiral, a British insurer...more

Ballard Spahr LLP

Guidance Addresses Mental Health Parity

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The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued a set of Frequently Asked Questions and Answers that, among other things, implement certain of the recommendations included in a report...more

Faegre Drinker Biddle & Reath LLP

Transparency's Opaque Beginning: CMS Starts Implementing ACA Transparency Requirements

Based on QHP Certification instructions issued on July 22, 2016, the Centers for Medicare and Medicaid Services (CMS) will collect administrative and performance data from health insurers that participate in the federally-run...more

Womble Bond Dickinson

ERISA Preemption: Don't Tread on my Uniform System of Plan Administration

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On March 1 the U.S. Supreme Court again reinforced the broad preemptive scope of the Employee Retirement Income Security Act of 1974, 29 U.S.C.A. §1001. In Gobeille v. Liberty Mutual Insurance Co., 136 S. Ct. 936, the court...more

Arnall Golden Gregory LLP

Section 1557 of the ACA: The Legal Side of Health Equity

This week marks the end of National Minority Health Month and its 2016 theme of “Accelerating Health Equity for the Nation.” This month, the HHS Office of Minority Health’s goal was to “raise awareness of the health...more

Miles & Stockbridge P.C.

SCOTUS ERISA Cases, Part Two: Preemption of State Healthcare Claims Database

This is the second article of a three part series summarizing employee benefit issues that are being argued in front of the U.S. Supreme Court during the current October 2015 term. Part One provided an outline of Montanile v....more

Robinson & Cole LLP

U.S. Supreme Court Reaffirms ERISA’s Preemption Provisions as Applied to State Health Law Reporting Requirements

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Recently, the U.S. Supreme Court, in Gobeille v. Liberty Mutual Insurance Co., 2016 U.S. LEXIS 1612, underscored the broad extent to which the preemption language of the Employee Retirement Income Security Act of 1974...more

Bond Schoeneck & King PLLC

Cybersecurity and Data Privacy: Big Win for Self-Insured ERISA Plans at Supreme Court (3/16)

On March 1, the Supreme Court issued a decision in Gobeille v. Liberty Mutual Insurance Company that delivered a big win for self-insured group health plans. The case involved a challenge to a Vermont law that required...more

McGuireWoods LLP

Supreme Court: ERISA Pre-empts Vermont’s Health Data Collection Law as Applied to Self-Insured Health Plans

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In Gobeille v. Liberty Mut. Ins. Co., No. 14-181, 2016 U.S. LEXIS 1612 (Mar. 1, 2016), the U.S. Supreme Court held that ERISA pre-empts Vermont’s “all-payer database” law – to the extent it is applied to self-insured health...more

Patrick Malone & Associates P.C. | DC Injury...

As corporations step up health care activity, it’s time to be wary

Just how much do you trust big companies, including the one you work for, with your health information? That issue may become increasingly important as employers campaign to help themselves and their employees by banding...more

Foley & Lardner LLP

Health Conscious? The EEOC Is Expanding Incentives for Employees’ Spouses

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Employee wellness programs are frequently a source of ulcer-causing angst for employers, but the Equal Employment Opportunity Commission (EEOC) is making moves to treat some of the underlying issues. Late last week, the EEOC...more

King & Spalding

CMS Proposes Sweeping Changes to Medicare Reimbursement for Clinical Diagnostic Laboratory Tests

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First Data Collection Period for Clinical Laboratories Is July 1, 2015 to December 31, 2015 - In the October 1, 2015 Federal Register, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule...more

Foley & Lardner LLP

Navigating the Diagnostic Commercialization Process

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Guest Post By: Perry Dimas, Senior Vice President and General Manager for Premier Source, part of AmerisourceBergen The 2015 Business of Personalized Medicine Summit was an inspiring day with talented professionals. One...more

Foley & Lardner LLP

Clinical Laboratories: Proposed Rule Implements Requirements for Reporting and Payment Based on Private Payer Rates

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As required by a 2014 statute, CMS has issued proposed regulations (Proposed Rule) implementing new requirements for laboratory reporting of, and eventually basing Medicare payment on, rates for clinical laboratory services...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

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