law

The President's Health Insurance Reform Faces Additional Lawsuits

This past June, the United States Supreme Court issued the first decision addressing the legality of the Patient Protection and Affordable Care Act (PPACA).  While that decision largely upheld PPACA, several other legal actions were also filed challenging various provisions of the law.   These cases were put on hold pending the outcome of June’s decision; however they are now under active consideration again. 

U.S. Senate Bill Aims to Remove Broker Commissions from MLR Formula

Love it or hate it, the Affordable Care Act has sparked a great deal of debate within the health care industry. One section of the Patient Protection and Affordable Care Act (PPACA) that has proven to be particularly problematic is a provision establishing Medical Loss Ratio (MLR) benchmarks for health insurance carriers. Several congressional bills have been filed in an attempt to remedy the situation. 

U.S. Supreme Court Gets Ready to Review Legality of PPACA as Qualifications of Two Justices Questioned: Full Court Likely to Hear Case

Earlier this month, the Supreme Court denied a motion by Freedom Watch arguing that Justice Elena Kagan should recuse herself from hearing the upcoming challenge to the Patient Protection and Affordable Care Act (PPACA). The law, often referred to as the “Affordable Care Act,” will be reviewed by the U.S. Supreme Court later this year. 

Obama Administration Defends Affordable Care Act in Opening Brief Filed with U.S. Supreme Court

On January 6, 2012, the U.S. Department of Justice (DOJ) filed a brief with the U.S. Supreme Court in support of the Patient Protection and Affordable Care Act (PPACA), one of the most talked about pieces of legislation passed in recent memory. In addition, over a half dozen amicus curiae briefs have been filed since then by interested parties wanting to weigh in on the case.  Oral arguments on the merits of the new health care reform law are scheduled for late March. 

Health Insurers Facing New Financial Pressure Points under Emerging Reforms: MLR Restrictions & ICD-10 Conversion Add to Complexity

The Patient Protection and Affordable Care Act (PPACA) is not only forcing health insurers to undergo fundamental changes in the way they do business, but the law is requiring new infrastructure investment while also mandating Medical Loss Ratios (MLR) that limit the amount insurers can spend on administrative costs.   

Eleventh Circuit Court of Appeals Rules PPACA's Mandate to Buy Health Insurance Unconstitutional: Decision Leads to a Split in Federal Appellate Courts

A recent ruling by the U.S. Court of Appeals for the Eleventh Circuit has declared the ‘individual mandate’ to purchase health insurance unconstitutional, which is a core element of the Patient Protection and Affordable Health Care Act (PPACA). Two out of three judges found the mandate that forces individuals to purchase health insurance represents an unprecedented and unconstitutional expansion of the power of Congress to regulate interstate commerce.

President Signs into Law Repeal of PPACA’s 1099 Filing Requirement

In a rare bipartisan moment, President Obama signed into law on Thursday [GC1] the repeal of the new 1099 filing requirement, which was initially mandated as part of the Patient Protection and Affordable Care Act (PPACA). [1]One of the more controversial provisions of PPACA, Section 906 created a new obligation for corporations to file a 1099 on each business transaction of $600 or more and to provide the payee with a copy. [2] This statutory obligation was more fully developed in §6041 of the Internal Revenue Code.

New Accountable Care Organization Draft Rules Released

What is all of the hoopla about Accountable Care Organizations, more commonly known as ACOs? Last week, the long-awaited proposed regulations were issued. Now we might have some answers.  

The draft rules for the establishment and operation of ACOs, authorized under Section 3022 of the Patient Protection and Affordable Care Act[1] (PPACA), were released on March 31.[2] The ACO interim rules, which exceed 400 pages, are being published for public comment. To review the proposed rules, click here.[GC1]  As with any set of proposed rules released for public comment, we can anticipate changes to these rules before they become law.