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Statutory Interpretation Health Insurance

Hogan Lovells

Supreme Court affirms constitutionality of U.S. Preventive Services Task Force

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On June 27, 2025, the Supreme Court in Kennedy v. Braidwood Management, Inc. upheld the structure of the U.S. Preventive Services Task Force (USPSTF, or “Task Force”), overturning a Fifth Circuit decision that had ruled that...more

Ballard Spahr LLP

Two Recent Supreme Court Injunction Rulings Support Affordable Care Act

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Two recent U.S. Supreme Court rulings support provisions of the Affordable Care Act, one directly and one indirectly....more

Seyfarth Shaw LLP

SCOTUS on ACA Challenge: Seriously Guys, We’re Doing This Again?

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In a closely watched decision, the Supreme Court has upheld the authority of the U.S. Preventive Services Task Force (Task Force), preserving the Affordable Care Act’s (ACA) requirement that health plans cover preventive...more

Proskauer - Health Care Law Brief

No Surprises Here! Fifth Circuit Holds NSA Provides No Private Right of Action to Enforce IDR Awards, Deepening Judicial Divide...

In a recently issued opinion, the Fifth Circuit has added yet another chapter to the growing debate over whether providers may seek judicial enforcement of Independent Dispute Resolution (“IDR”) awards issued under the No...more

Troutman Pepper Locke

U.S. Supreme Court Holds Medicaid’s Any-Qualified-Provider Provision Does Not Confer Enforceable Rights

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The U.S. Supreme Court, in a 6-3 decision, ruled that the Medicaid Act’s any-qualified-provider provision does not confer individual rights enforceable under 42 U.S.C. §1983. This decision reverses the Fourth Circuit’s...more

Jackson Lewis P.C.

Timing Is Everything: SCOTUS Shuts Down Retiree’s ADA Post-Employment Benefits Claim

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Do former employees have the right to sue their previous employer under Title I of the Americans with Disabilities Act (ADA) for discrimination in the administration of post-employment fringe benefits? Resolving a circuit...more

Pullman & Comley - Labor, Employment and...

Federal Court Decision Reshapes ACA Enforcement by HHS and IRS

The recent federal district court decision in Faulk Company, Inc. v. Xavier Becerra, et al., No. 24-cv-00609-P (N.D. Tex. 2025) significantly alters the primary mechanism used by the U.S. Department of Health and Human...more

King & Spalding

Affordable Care Act Preventative Care Mandate At Risk Pending Supreme Court Decision

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A case pending before the Supreme Court could jeopardize the Affordable Care Act’s (ACA) mandate that certain preventive services be provided on a first dollar coverage basis to plan members. Kennedy v. Braidwood Management...more

McDermott+

Breaking Down the New No Surprises Act FAQs Post-TMA III (June 2025 Update)

McDermott+ on

UPDATE: On May 30, 2025, the Fifth Circuit granted the TMA III plaintiffs’ petition for rehearing en banc, which was previously filed on December 16, 2024. Of note, the Fifth Circuit’s mandate has not yet been issued, so as a...more

Hanson Bridgett

Peer Review by Licentiates Only: Beware Health Care Service Plans!

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On February 19, 2025, the California Court of Appeal published a decision, Lin v. Board of Directors of PrimeCare Medical Network, Inc., 108 Cal.App.5th 1163, emphasizing California Business and Professions Code’s requirement...more

Seyfarth Shaw LLP

HHS’ Withdrawal of 2022 Guidance Raises Questions about Coverage for Gender-Affirming Care

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In a move with potentially significant implications for entities subject to the Affordable Care Act, the Department of Health and Human Services (HHS) has reversed course and now contends that Section 1557 of the Affordable...more

Ballard Spahr LLP

Courts Invalidate ACA Regulations Following Demise of Chevron Deference

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Following the U.S. Supreme Court’s recent decision to overturn its landmark 1984 Chevron decision, three district courts have struck down provisions in nondiscrimination regulations under the Affordable Care Act that prohibit...more

Robinson+Cole Health Law Diagnosis

Supreme Court Decides in Favor of 340B Hospitals Regarding Medicare Reimbursement Methodology

On June 15, 2022, the U.S. Supreme Court unanimously ruled in favor of “340B” hospitals in a notable statutory interpretation case concerning how the federal Medicare program reimburses hospitals for prescription drugs. The...more

Mitchell, Williams, Selig, Gates & Woodyard,...

State Hospital Association Fights Changes to Medicaid DSH Payment Rules

For hospitals that “serve a disproportionate number of indigent patients” Medicaid allows for supplemental payments to help ensure their financial viability. The calculation of those supplemental payments recently became the...more

Seyfarth Shaw LLP

ERISA Preemption — The Courts of Appeal Continue to Rule As They Await Further Supreme Court Attempts To Define, Once and for All,...

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Synopsis: Two Courts of Appeal reach opposite results on ERISA preemption, thus continuing the judicial quest for a definitive meaning of ERISA preemption. Stay tuned for more such decisions, and yet more Supreme Court...more

Shook, Hardy & Bacon L.L.P.

Privacy and Data Security Alert | June 2019 #2

Maine Bill Requires ISPs to Obtain Opt-In Consent from Customers - The Maine legislature has passed a bill that requires internet service providers (ISPs) operating in Maine to obtain express, affirmative consent from...more

Eversheds Sutherland (US) LLP

Trenchant Analysis or Jiggery-Pokery? U.S. Supreme Court Upholds Affordable Care Act

In a 6-3 decision on June 25, 2015 in King v. Burwell, the U.S. Supreme Court held that tax credits are available under the Patient Protection and Affordable Care Act (Affordable Care Act or PPACA) to all eligible Americans,...more

Nossaman LLP

To Understand King v. Burwell Look To Yates v. US

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On March 4, 2015, the U.S. Supreme Court heard argument in King v. Burwell, the most publicized case to reach the high court in some time. The issue is whether certain tax subsidies essential to the proper fiscal management...more

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