Earlier this week, in Roman Catholic Archdiocese of New York v. Sebelius, U.S. District Judge Brian Cogan in the Eastern District of New York permanently enjoined the government from enforcing regulations mandating coverage for contraceptive and sterilization services by religious organization health plans.

The Patient Protection and Affordable Care Act requires health insurance plans to provide preventative medical services. 
Continue Reading EDNY Judge Enjoins Enforcement of HHS Mandate

(This post was authored by Heather Harrison, an associate in the Labor & Employment practice at Farrell Fritz)

Although key provisions of the Patient Protection and Affordable Care Act (ACA) have been delayed until 2015, one important notice requirement is just around the corner. By October 1, 2013, virtually all employers must provide written notice to their employees


Continue Reading Affordable Care Act Employer Notice Deadline Nears

On May 29, 2013, the US Departments of Health and Human Services, Labor, and Treasury issued final regulations regarding wellness programs under the Patient Protection and Affordable Care Act (the “ACA”).  Wellness programs are programs offered by employers, or directly by insurance companies to their enrollees, to improve health and promote fitness. The ACA, in conjunction with the Health Insurance


Continue Reading Wellness Programs Under the Affordable Care Act

Over fifty cases across the country have challenged regulations promulgated under the Patient Protection and Affordable Care Act (“PPACA” or “Obamacare”) that require employer group health insurance plans to provide coverage for contraception, sterilization and related counseling (the “HHS Mandate”).  Suits have been filed by religiously-affiliated organizations as well as private business owners, asserting that the HHS Mandate will require
Continue Reading Are Suits Opposing Obamacare Mandates Ripe?

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

As Chris Kutner explained in his January 4, 2013 post, the Patient Protection and Affordable Care Act of 2010 (“PPACA” or “Obama Care”) requires, beginning in 2014, that employers with 50 or more full-time employees (“large employers”) offer “affordable” health insurance to their employees. Failure to do so will subject the employer to penalties. Recently published IRS proposed regulations


Continue Reading “Affordable” Health Coverage Under Obama Care

The Patient Protection and Affordable Care Act of 2010 (“PPACA” or “Obama Care”) requires, beginning in 2014, that employers with 50 or more full-time employees (“large employers”) offer “affordable” health insurance to its employees. Failure to do so will subject the employer to penalties.

Future blog postings will address the coverage requirements and penalties under PPACA, but to start, what


Continue Reading Obama Care Employer Mandates: Who Must Comply?

In late October the U.S. Attorney’s Office in the Southern District of New York announced the settlement of a False Claims Act case against Westchester Medical Center (“WMC”) for $7 million, for submitting false reimbursement claims to Medicaid from August 2001 through June 2010 involving outpatient behavioral health services.  The settlement is to be paid in equal amounts of


Continue Reading Hospital Settles False Claims Act Case For $7 Million

Now that the Affordable Care Act has been upheld by the U.S. Supreme Court, the requirement to control costs is critical.  One thing we can learn from the experience of near universal coverage in Massachusetts is that providing access to more citizens without containing costs is a recipe for disaster.  In 2006 Massachusetts achieved coverage for roughly 98% of its


Continue Reading Affordable Care Act: Bundling Payments to Control Costs

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.