Health Care Law Blog

Determination of Affordability and Minimum Value Under PPACA

The Patient Protection and Affordable Care Act ("PPACA") requires "large employers" to provide affordable health coverage of a minimum value to full-time employees and their dependents starting in 2014.  A large employer failing to do so may be subject to penalties.

Coverage is considered affordable to an employee if the employee portion of the self-only premium for the employer's lowest-cost coverage does not exceed 9.5% of the employee's household income, but only if the lowest-cost coverage provides a minimum value.  Read More ›

Categories: Employee Benefits, Health Care Reform

Posted by: Johanna M. Novak

  |  Contact Author

Share  | 

National Practitioner Data Bank

Hospitals are required to report certain adverse clinical privileging actions and medical malpractice payments to the National Practitioner Data Bank (NPDB).  Since the NPDB was established by the Health Care Quality Improvement Act (HCQIA) in 1986, compliance with these reporting obligations has been largely entrusted to hospitals with little enforcement action by the United States Department of Health and Human Services.  There are now reports that the federal government has begun auditing compliance by hospitals with the NPDB reporting requirements. Read More ›

Categories: Audits, Compliance, Hospitals, Physicians

Contact Author

Share  | 

Blue Cross Changes on the Horizon?

Changes to the health insurance market in Michigan may soon be changing due to the Michigan House of Representatives’ approval of Senate Bills 1293 and 1294 (the “Senate Bills”) on December 6, 2012.  The introduction of the Senate Bills follow Governor Snyder’s proposed overhaul of BCBSM discussed here and directly address the corporate organization and continued operation of Blue Cross Blue Shield of Michigan (“BCBSM”) in our state.  In brief, the Senate Bills authorize BCBSM to establish, own, operate and merge with a nonprofit mutual disability insurer.  They also generally prohibit BCBSM from using “Most Favored Nation Clauses” in provider contracts beginning February 1, 2013.  While the Senate Bills are not final until Governor Snyder signs them into law, given his previous support it is likely he will give his approval. A more detailed analysis of the Senate Bills will be provided if the Governor does indeed sign them into law.

Categories: Billing/Payment, Insurance, Regulatory

Posted by: Mindi M. Johnson

  |  Contact Author

Share  | 

Michigan Will Not Operate a State-Based Health Insurance Exchange

Over the past several weeks, the nation has seen a flurry of announcements issued by states as to how such states will implement and operate the health insurance exchanges (“HIE”) required by the Affordable Care Act. States have three options as to how they may run their HIEs: Read More ›

Categories: Health Care Reform, Health Insurance Exchange, Regulatory

Posted by: Jennifer Kildea Dewane

  |  Contact Author

Share  | 

Proposed Health Care Reform: 3 Sets of Regulations Released During Holiday Week

On Monday, November 26, 2012 the Department of Health and Human Services ("DHHS") issued proposed rules on:  (1) standards related to essential health benefits, actuarial value and accreditation, and (2) health insurance market rules and rate review.  The Department of Treasury, the Department of Labor, and DHHS issued combined proposed rules for the incentives of wellness programs. Comments on these proposals must be received no later than December 26, 2012.  So those interested in commenting have a short window to examine the three sets of rules.  For more on these topics and how they will impact you, stay tuned to the Foster Swift Health Care Blog.

Categories: Health Care Reform, Regulatory

Contact Author

Share  | 

Insurance Exchange Deadlines Further Extended

As we previously reported, the Department of Health & Human Services (“DHHS”) extended some important deadlines for states establishing State-Based Insurance Exchanges or State Partnership Exchanges for 2014.  Specifically, DHHS extended the submission deadline for State-Based Exchange Blueprints to December 14, 2012.  However, the administration previously still required states to submit Declaration Letters of their intent to build state-based Health Insurance Exchanges by November 16^th.  However, as of Thursday (November 15^th), only 17 states and the District of Columbia had committed to building their own Exchanges.  This is far fewer than envisioned by the Obama administration when the law was passed in 2010. To give states more time, the Obama administration extended the deadline for the Declaration letters until December 14^th.  Thus, both Blue Prints of the specifics of the Exchange and Declaration Letters of states wishing to run their own Exchange are due on December 14^th. Read More ›

Categories: Health Care Reform, Health Insurance Exchange, Insurance

Contact Author

Share  | 

Deadline to Submit Blueprints for State-Based Insurance Exchanges Extended

Last Friday, the U.S. Department of Health & Human Services ("DHHS") extended important deadlines related to those states desiring to establish State-Based Insurance Exchanges or State Partnership Exchanges for 2014.  Specifically, Kathleen Sebelius, Secretary of DHHS, advised governors that DHHS had extended certain deadlines related to the submission of Declaration Letters and Blueprints, stating that DHHS is committed to providing states with flexibility for building a marketplace that meet each state's needs. Read More ›

Categories: Health Care Reform, Health Insurance Exchange

Posted by: Jennifer Kildea Dewane

  |  Contact Author

Share  | 

Patient Protection and Affordable Care Act Marches On

As President Obama moves into his second term, health care reform moves forward with him. Wholesale repeal of the Patient Protection and Affordable Care Act (PPACA) now seems highly unlikely. With the majority of the PPACA provisions slated to go into effect in 2014, employers need to be ready.

Foster Swift has developed guides to aid employers with their preparation efforts. Click the links below to download these guides.

Documents updated 07-12-2013

If you have any questions regarding health care reform, please contact a member of the Foster Swift Health Care Law Group.

Categories: Employee Benefits, Employment, Health Care Reform, Hospitals, Insurance, Physicians, Regulatory

Contact Author

Share  | 

Recap of 2012 Healthcare Forum

On October 11, 2012, the Lansing Regional Chamber of Commerce hosted its annual Healthcare Forum.  A half-day event, the Healthcare Forum brings together mid-Michigan leaders in the health care industry to provide updates on the latest issues.  This year’s forum, titled “Countdown to 2014 – The Tools to Conform to Healthcare Reform,” drew nearly 100 attendees and featured topics including: Read More ›

Categories: Compliance, Employee Benefits, Employment, Health Care Reform, Labor Relations, Regulatory

Contact Author

Share  | 

Visa Options for Foreign Nurses and Legislative Update

Curiously, traditional registered nurses ("RNs"), excepting Canadian and Mexican RNs under NAFTA, lack a general temporary visa category to work in the United States. While there are favorable provisions for an RN to obtain permanent resident status (a “Green Card”) based upon employment, the lengthy eligibility wait time for the permanent visa category limits the practical usefulness of these provisions in many cases. Currently, temporary visa options for nurses are limited to the following. Read More ›

Categories: Employment, Hospitals, Physicians

Posted by: Ryan E. Lamb

  |  Contact Author

Share  |