Supreme Court Will Hear Another ACA Case

By | Triage | November 10, 2014
Supreme Court Will Hear Another ACA Case

The Affordable Care Act has once again made its way onto the Supreme Court’s calendar.  On Friday, the Justices voted to accept King v. Burwell for hearing this term.  The issue this time is whether tax subsidies may be given to individuals who purchase insurance through the federal exchange, rather than an insurance exchange run by one of the states. 

The Affordable Care Act—Countdown to Compliance: IRS Puts the Kibosh On Health Plans That Fail to Cover Hospital or Physician Services

By | Employment Matters Blog | November 10, 2014
The Affordable Care Act—Countdown to Compliance: IRS Puts the Kibosh On Health Plans That Fail to Cover Hospital or Physician Services

In a previous post, we described an Affordable Care Act compliance strategy—referred to commercially as a “minimum value plan” or “MVP”—that involves an offer of group health plan coverage that, while similar in most respects to traditional major medical coverage, carves out inpatient hospital services.

Monday Morning Regulatory Review: SCOTUS to Review Obamacare Subsidy Rule; Final Rule Statute of Limitations; And WOTUS Comments

Monday Morning Regulatory Review:  SCOTUS to Review Obamacare Subsidy Rule; Final Rule Statute of Limitations; And WOTUS Comments

Last week in regulations was entirely expected – it was all just a matter of time.  The United States Supreme Court (SCOTUS) agreed that it will decide this Term whether the Internal Revenue Service (IRS) may, by regulation, extend Obamacare (Patient Protection and Affordable Care Act or PPACA) subsidies to participants in federally-operated health care exchanges.

Affordable Care Act Challenged Again: Supreme Court Will Examine Subsidy Tax Credits

By | Health Law Advisor | November 7, 2014
Credit: Flickr user zacklur

In something of a surprise, the Supreme Court today granted certiorari in the Fourth Circuit case of King v. Burwell, in which the court of appeals had upheld the government’s view that the Affordable Care Act makes federal premium tax credits available to taxpayers in all states, even where the federal government, not the state, has set up an exchange.

OMHA’s Second Appellant Forum Prompts Opportunity for Stakeholder Comments On Reducing Appeals Backlog

By | Health Law Advisor | November 7, 2014

On October 29, 2014, the Office of Medicare Hearings and Appeals (“OMHA”) hosted its second Medicare Appellant Forum (“Forum”) to address the status of the Medicare appeals backlog and related processing delays of Administrative Law Judge (“ALJ”) appeals, which are the third level of the Medicare appeals process that is available to suppliers, providers, and Medicare beneficiaries to challenge denied claims.