Tag Archives: patient protection and affordable care act

CMS Issues Proposed Regulations Concerning Disclosure Requirements for Certain Imaging Services Under the Stark Law’s In-Office Ancillary Services Exception

On June 25, 2010, the Centers for Medicare & Medicaid Services (“CMS”) issued theProposed Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2011 (the “Proposed Rule”).[1] Significantly, among its revisions are the proposed regulations implementing Section 6003 of the Patient Protection and Affordable Care Act (“PPACA”)[2] concerning the physician self-referral provisions of Section 1877 of the Social Security Act, commonly known as the “Stark Law.”[3] Specifically, the Proposed Rule outlines a proposed disclosure requirement for certain imaging services (the “Disclosure Requirement”) provided under the umbrella of the In-Office Ancillary Services Exception to the Stark Law.[4] Suppliers and providers of imaging services should consider submitting comments on the Proposed Rule to CMS in either the specified areas requested by CMS or the other areas of concern related to this topic. The deadline to submit such comments is August 24, 2010. Also, as indicated in the Proposed Rule, the Disclosure Requirement will take effect on January 1, 2011—one year later than the potentially retroactive effective date of January 1, 2010, specified in PPACA. 

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PPACA Amends Rehabilitation Act to Mandate Standards for Medical Diagnostic Equipment to Accommodate Individuals with Disabilities

by Shawn Gilman and Frank C. Morris, Jr.

A little-noticed provision of the Patient Protection and Affordable Care Act (PPACA) will significantly impact both health care manufacturers and providers.  The provision amends the Rehabilitation Act of 1973 to require regulations by March 23, 2012, mandating that all medical diagnostic equipment and health care provider locations be able to accommodate the needs of individuals with disabilities.  This requirement would mean a redesign of both diagnostic equipment and locations for patient interactions to assure that individuals with disabilities who could not utilize currently available diagnostic equipment or provider locations will, in the future, have access to the care and services available to individuals without disabilities.  They must be able to have access to—and independently be able to enter, use, and exit—the equipment to the maximum extent possible.  This is significant because of the often high cost of diagnostic equipment and space requirements at provider locations.

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HEALTH REFORM: PPACA Amends Rehabilitation Act to Mandate Standards for Medical Diagnostic Equipment to Accommodate Individuals with Disabilities

The Patient Protection and Affordable Care Act (“PPACA”) contains a provision that will significantly affect all types of health care manufacturers and providers.[1] Section 4203 of PPACA amends Title V of the Rehabilitation Act of 1973 (“Rehab Act”) by adding a new section that requires the Architectural and Transportation Barriers Compliance Board (“ATBCB”), in consultation with the Food and Drug Administration (“FDA”) Commissioner, to promulgate regulatory standards for medical diagnostic equipment used in physician offices, clinics, emergency rooms, hospitals, and other medical settings to accommodate the needs of individuals with disabilities. Particularly, the standards are intended to ensure that individuals with disabilities (a) have access to and use of the equipment, and (b) will independently be able to enter, use, and exit the equipment to the maximum extent possible. The medical diagnostic equipment explicitly mentioned in this provision includes examination tables and chairs, weight scales, and radiological equipment.

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HEALTH REFORM: New Regulations Implement Dependent Child Medical Coverage to Age 26

The Patient Protection and Affordable Care Act1 and Health Care and Education Reconciliation Act2 (together, the “Act”) added the requirement that group health plans that cover dependents now cover them through the age of 26. In the first joint guidance issued from all three of the responsible government agencies, Interim Final Rules (the “Regulations”)3 have clarified and applied the requirement. However, employers may be surprised by some of the details added by the Regulations.

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HEALTH REFORM: Health Care Reform Increases Employer Exposure to Claims, Penalties and Litigations

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.” 

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Patient Protection and Affordable Care Act – Advisory Boards, Commissions, Councils and Committees

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). 

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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.

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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. 

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HEALTH REFORM: Health Care Reform: What Employers Need to Know

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (“Act”), which provides for significant changes in the delivery of health care. The Health Care and Education Reconciliation Act of 2010 (“Reconciliation Bill”), which reconciles and amends certain provisions of the Act, was signed into law by President Obama on March 30, 2010. The following is a high-level summary that identifies some of the key provisions of the Act, as amended by the Reconciliation Bill. 

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HEALTH REFORM: Health Care Reform: Tax Provisions Affecting Large Employers

The Patient Protection and Affordable Care Act (the “Act“) was signed into law by President Obama on March 23, 2010. The Health Care and Education Reconciliation Act of 2010 (the “Reconciliation Bill“), which reconciles and amends certain provisions of the Act, was signed into law by President Obama on March 30, 2010. The tax provisions in the Act, as amended by the Reconciliation Bill, will significantly impact how large employers structure their health benefits. At a minimum, employers will be subject to new administrative obligations relating to their employee health benefits. Given that some of the more significant provisions will not become effective for a number of years, employers will have time to become familiar with and plan accordingly for such new demands. The tax-related provisions of the Act that affect large companies and employers include:

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