The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (the “Act”) implements significant changes to the provision of health care and health coverage applicable to all aspects of health care delivery, operation and administration. The Act imposes many different requirements on employers that become effective over time. These requirements are discussed in more detail in our Client Alert of April 8, 2010, entitled “Health Care Reform: What Employers Need to Know.”
In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act and related amendments (“ACA”) to help achieve significant health reform in the United States. ACA authorized the creation of numerous advisory boards, commissions, councils and committees.
Each of these advisory bodies has its own purpose, membership, and composition, with different policies governing pay and reimbursement, applicable conflict of interest rules, effective dates and term limits. Several will operate consistent with the Federal Advisory Committee Act (5 U.S.C. App.) with the exception of section 14 of that Act (which addresses the termination, renewal and continuation of advisory committees).
HEALTH REFORM: Health Care Reform Legislation Amends the Fair Labor Standards Act to Give the U.S. Department of Labor Increased Enforcement Authority Over Health Care
The Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (the “Act”), significantly impacting the delivery of health care, also amends the Fair Labor Standards Act (“FLSA”). The FLSA amendments impose certain employer responsibilities in providing health care benefits, confer whistleblower protections and authorize the U.S. Department of Labor (“DOL”) to undertake increased enforcement related to health care. Employers have new requirements to learn, and to implement, under the FLSA, irrespective of their size or the number of employees in their workforce.
Newly Constituted Administrative Review Board Allows Equitable Considerations to Extend 90-Day Statute of Limitations for Whistleblower Claims
Employers who thought they were free of exposure if no complaint was filed within the statute of limitations applicable in Sarbanes-Oxley (“SOX”) and other whistleblower claims administered by the Secretary of Labor need to recalibrate their risk based on a recent decision allowing equitable estoppel.
In Hyman v. KD Resources, an employee missed the 90-day SOX statute of limitations by filing his complaint 160 days after he was discharged. Two newly appointed members of the Administrative Review Board (“ARB”) allowed the complaint to survive and remanded it to the Administrative Law Judge who had dismissed it as untimely.
Congress has extended the subsidy for COBRA benefits through May 31, 2010. The previous extension of the COBRA subsidy had expired on March 31, 2010. The COBRA subsidy provides a 65% health insurance premium subsidy for up to 15 months to qualified employees who are involuntarily terminated from their employment between September 1, 2008 and […]
As we reported in our Client Alert of December 24, 2009 (“UPDATE: Cobra Subsidy: What it Means for Employers Now“), President Obama signed into law the Department of Defense Appropriations Act, 2010 (the “Defense Appropriations Act”), which, among other things, extended and expanded certain provisions of the American Recovery and Reinvestment Act of 2009 (“ARRA”) pertaining to premium assistance for benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985 (“COBRA”). The Defense Appropriations Act extended the COBRA premium subsidy for assistance-eligible individuals who became eligible for COBRA from the period that began September 1, 2008, and ended on December 31, 2009, to the period that ended on February 28, 2010.
Medicare Providers and Suppliers Take Note: PPACA Reduces the Timely Filing Deadline for Medicare Fee-For-Service Claims to One Year
In March 2010, President Obama signed into law the Patient Protection and Affordable Care Act (“PPACA”) and related legislation which provide significant changes in the delivery of health care. One provision that impacts Medicare operations immediately is Section 6404 of PPACA. Section 6404 reduces the statutory timely filing deadline for Medicare fee-for-services claims under Medicare Parts A and B to one (1) year, effective for all Part A and B services furnished on or after January 1, 2010. This provision is self-executing.
This is a bold but necessary move by a government looking to build more clean renewable power in the Province. Hydro-electric power is a reliable and preferred form of electricity generation in British Columbia with a great history. Premier W.A.C Bennett’s hydro-electric vision in the 1960’s helped the Province develop to what it is today. The incredible legacy dam system he provided now allows British Columbians to enjoy the fruits – inexpensive, domestically generated, clean electricity.
Suits in the name of the United States under the Federal False Claims Act (“FCA”) brought by private individuals known as qui tam relators are among the most common forms of whistleblower actions in the federal system. The Supreme Court rendered its much-anticipated decision in Graham County Soil and Water Conservation District, et al. v. United States ex rel. Wilson (pdf), imposing a significant limitation on the ability of these relators to satisfy an important jurisdictional bar.
The FCA authorizes both the Attorney General and private qui tam relators to bring actions against persons who make or facilitate fraudulent claims for payment from the United States. However, in the absence of the government, a relator will be barred from proceeding on his own if the action is based upon the public disclosure of allegations or transactions in, inter alia, “a congressional, administrative, or Government Accounting Office (“GAO”) report, hearing, audit, or investigation.” 31 U. S. C. §3730(e)(4)(A). The Graham County case involved federal contracts and funding for the repair of flood damage. The relator, Wilson, a local government employee, alerted both federal and county and state officials to irregularities in performance. Both the county and the state issued reports making findings about these potential irregularities and Wilson thereupon filed a qui tam action against the county conservation districts administering the contracts. The District Court dismissed for lack of jurisdiction because it held that the allegations publicly disclosed in the county and state reports constituted “administrative” reports under the FCA’s public disclosure bar. The Fourth Circuit reversed, holding that only federal administrative reports may trigger the public disclosure bar.
On March 29, 2010, the U.S. Food and Drug Administration (“FDA“) published a proposed rule titled Direct-to-Consumer Prescription Drug Advertisements; Presentation of the Major Statement in Television and Radio Advertisements in a Clear, Conspicuous, and Neutral Manner (“Proposed Rule“).[i] The Proposed Rule would require direct-to-consumer (“DTC“) television and radio advertisements to present the mandated “Major Statement” for major side effects and contraindications “in a clear, conspicuous, and neutral manner.” The FDA is accepting written comments on the Proposed Rule until June 28, 2010.