Tag Archives: healthcare reform

HEALTH REFORM: Federally Facilitated Exchanges Are Almost Ready

On March 1, 2013, the Center for Consumer Information and Insurance Oversight (“CCIIO”) and the Centers for Medicare & Medicaid Services (“CMS”) released lengthy and detailed draft guidance[1] regarding the federally facilitated exchanges (“FFEs”) that will operate in the 26 states[2] that have chosen not to establish their own exchange or partner with CMS. Although the guidance was issued in draft form, CCIIO and CMS allowed only two weeks for the public to submit comments and, as described below, CMS intends to start accepting issuer applications to the FFEs on April 1, 2013. As such, it seems unlikely that the guidance will be materially revised.

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HEALTH REFORM: HIPAA Omnibus Rule’s Impact on Notices of Privacy Practices

This health reform alert summarizes the key changes to the Notice of Privacy Practices (“NPP”)[1] requirements in the revised Health Insurance Portability and Accountability Act (“HIPAA”) regulations (the “Omnibus Rule”)[2] as well as what covered entities need to do to be compliant.[3] Because many covered entities may have modified their NPPs based on the Notice of Proposed Rulemaking issued on July 14, 2010 (“NPRM”),[4] this alert also details the similarities and differences between the NPRM and the Omnibus Rule related to NPPs. In addition, Table 1 of this alert provides a quick summary of the NPRM proposals adopted—or not adopted—by the Omnibus Rule.

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Healthcare Alert: Physician Payment Sunshine Act final rule issued

The long-awaited Physician Payment Sunshine Act final rule has been issued, as well as responses from the Centers for Medicare & Medicaid Services (CMS) to over 350 public comments submitted in response to the proposed rule. The final rule was published in the Federal Register on February 8, 2013.

Click here to view the final rule.

The Physician Payment Sunshine Act, which was passed as part of the Affordable Care Act in 2010, is intended to promote transparency of physician ownership and investment interests in health care manufacturers and group purchasing organizations (GPOs). Applicable manufacturers and GPOs will be required to annually report certain financial relationships with physicians, their immediate family members and teaching hospitals for the preceding year. CMS will then post the information on a public webpage which will be searchable and will have the ability to download content. 

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ILN Today Post


Regulators have recently issued a voluminous amount of guidance addressing how employers must comply with the Patient Protection and Affordable Care Act (PPACA).

Much of the guidance addresses the requirement that, effective January 1, 2014, affected employers must offer qualifying health care coverage to all full-time employees or pay a tax. While the regulations have generally been issued in proposed form, there is enough guidance for employers to develop a fairly detailed approach to PPACA compliance. Furthermore, failure to address issues now may subject a business to significant new taxes in 2014. More…

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Patient Protection and Affordable Care Act Alert-Issue 2: Health Care Reform — Practical steps for employers

The re-election of President Obama and the lack of change in the control of the houses of Congress effectively ensure that the provisions of Health Care Reform will remain in place and will continue along the path of implementation.

This is our second Alert in a series designed to help employers understand and address the effects of Health Care Reform on their businesses so they are in the best position to make decisions in response to these new requirements. Our first Alert dealt with the implementation of New Health Flexible Spending Account Limits. At this point, most of the regulatory guidance needed has not yet been issued. Therefore, we will provide the best possible guidance based on existing knowledge.

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Comparison of Stage 1 vs Stage 2 Meaningful Use

Sifting through the hundreds of pages of new rules can be overwhelming.  Luckily, CMS has provided comparison charts to help navigate the meaningful use changes coming our way with Stage 2.  Along with the new rules, CMS clarified that the earliest Stage 2 meaningful use is effective is fiscal year 2014 for hospitals and calendar year 2014 for eligible professionals (more on 2014 to come in future posts).

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SCOTUS Decision on the PPACA – Implications for Healthcare Industry Sectors Part I

Yesterday, we talked about the impact of the election on the PPACA, as well as the implications of the PPACA for employers. Today, we’ll delve into the implications for healthcare industry sectors with our final post in the series.

Lynn kicked it off by saying that before we go into each sector individually, she wanted to make an introductory comment. There are people who have asked why did the stock market reach bullish about healthcare stocks following the decision, but then not bullish about it, and whether anything can be read into this. Lynn said that whenever she reads these kinds of articles, she has to laugh, because each company is in their own relationship with entitlement programs and private health insurance, and they have different starting points and are in different states. 

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SCOTUS Decision on the PPACA – Impact of the Upcoming Election & Implications for Employers

Our series recapping the Epstein Becker & Green webinar on the Supreme Court’s Decision regarding Obamacare continues! Today, we’ll be talking about the impact of the upcoming election on the plan, as well as the implications for employers.

Impact of the Upcoming Election

Lynn asked the panelists to comment on the Presidential election and the swing states, saying that there wasn’t even agreement among the panelists as to which states are the swing states. Bill agreed, and said that both political parties count different states as swing states. He thinks that the six states that both parties agree on as swing states are Colorado, Nevada, Florida, Ohio, Virginia and Pennsylvania. 

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SCOTUS Decision on the PPACA – Potential Congressional Response

Last week, we talked about the implications of the Supreme Court’s decision for the states. Today, we’ll look at the potential Congressional response.

Lynn began by suggesting the panelists speak about the federal level, as she’s cynical about the 90% and 100% matching, when we’re going into a period of austerity. She said she would like them to talk about entitlement reform and deficit reduction, and asked whether the decision to expand Medicaid has a lot to do with people’s confidences that the 100% and 90% matching money will remain the law of the land at the federal level.  

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Overview and Analysis of the SCOTUS PPACA Decision – A Recap

After our 2012 Annual Meeting, I recapped a session from the conference that had focused on the topic of healthcare reform (See here, here and here). Once the Supreme Court announced their decision, Epstein Becker & Green’s healthcare experts once again came out to help us understand what’s in, what’s out and what’s next with their webinar on July 2nd.

Since it’s always good to hear from the experts, I thought I’d recap the webinar here for you, again, breaking it up into manageable bites (so to speak). 

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