Patient Protection and Affordable Care Act

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The U.S. Department of Health and Human Services (HHS) has issued final rule stating the future health insurance exchange (“Exchange”) and insurance issuer standards related to coverage of essential health benefits (EHB) and actuarial value. The final rule further establishes a timeline for when qualified health plans (QHPs) should be accredited in federally facilitated Exchanges.

Beginning January 1, 2014, non-grandfathered…

Continue Reading Essential Health Coverage Benefits – The ACA Final Rule

The Centers for Medicare & Medicaid Services (“CMS”) will be penalizing more than 2,000 hospitals nationwide starting in October 2012 under the Hospital Readmission Reduction Program (the “Program”).  A number of New York hospitals were included on the list of hospitals to which CMS will apply the readmission penalty to reimbursements, including Beth Israel Medical Center, John T. Mather Memorial …
Continue Reading CMS to Penalize Hospitals Under Hospital Readmissions Reduction Program

The United States Supreme Court has upheld the 2010 Patient Protection and Affordable Care Act’s  individual mandate not because it is as an exercise of Congressional power under the Commerce Clause, but because the mandate is within Congress’s power to lay and collect taxes.

On Medicaid expansion, the Court ruled that the Act violates the Constitution by threatening states with…
Continue Reading The Patient Protection and Affordable Care Act’s Individual Mandate is Upheld as a Tax.

With a decision by the Supreme Court on the constitutionality of the Patient Protection and Affordable Care Act expected shortly, the New York Times has published a simple interactive tool examining the potential impact of the decision if the Court were to strike all, some, or none of the provisions of the law commonly knows as “Obamacare”.
Continue Reading Potential Impact of Supreme Court Decision on Health Reform Law