Health Care Law Blog

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  | 

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  | 

Michigan will Pursue Federal Partnership for its Health Insurance Exchange

At the end of August, Governor Rick Snyder announced that Michigan will be pursuing a federal-state partnership for its health insurance exchange.  Health insurance exchanges are a requirement of the federal Health Care Reform law.  Health insurance exchanges are designed to  facilitate the purchase of health insurance by consumers through an online, cost-competitive forum.  Each state has the option to: (1) operate its own health insurance exchange; (2) partner with the federal government; or (3) allow the federal government to manage its health insurance exchange. Read More ›

Categories: Employee Benefits, Health Care Reform, Health Insurance Exchange, Insurance, Regulatory

Posted by: Mindi M. Johnson

  |  Contact Author

Share  | 

Foster Swift Lawyers Attend Annual State Bar of Michigan Health Care Law Section Meeting

Foster Swift lawyers were well represented at the Annual Meeting of the State Bar of Michigan's Health Care Law Section held on September 19th. Gilbert Frimet, Gary McRay, Jennifer Kildea Dewane, and Nicole Stratton, members of Foster Swift Health Care Law Practice Group, all traveled to Detroit to attend the meeting.  Read More ›

Categories: Health Care Reform, Health Insurance Exchange, Hospitals, Insurance, Medicare/Medicaid, Physicians, Regulatory

Contact Author

Share  | 

Proposed Rules Would Allow Physician Assistants to Prescribe Schedule 2 Controlled Substances

The Board of Medicine and the Board of Osteopathic Medicine have proposed amendments to the administrative rules governing the delegation of prescribing authority to physician assistants.  Under the existing rules, a physician may only delegate to physician assistants the authority to prescribe controlled substances that are listed in the Federal Drug and Enforcement Administration’s (“DEA’s”) Schedules 3 to 5.  The proposed amendments would eliminate that limitation and allow physicians to authorize physician assistants to prescribe Schedule 2 controlled substances. Read More ›

Categories: Hospitals, Physicians, Regulatory

Contact Author

Share  | 

Governor Snyder Proposes Total Overhaul to Blue Cross Blue Shield of Michigan

Governor Rick Snyder in a press conference this morning proposed a total overhaul of Blue Cross Blue Shield of Michigan ("BCBSM").  Governor Snyder's proposal would:

1. covert BCBSM to a non-profit mutual company;
2. end its tax exemption; and
3. remove Attorney General review of requested rates. 

In essence, Michigan would treat BCBSM as it would any other health insurer as BCBSM would be regulated by the Insurance Code.  While this proposal may seem drastic, it is not surprising given recent regulation orders by the Office of Financial and Insurance Regulation ("OFIR") curtailing BCBSM's use of most favored nation clauses ("MFN Clauses") and rejecting the low rates that it charges to hospitals and other providers. Read More ›

Categories: Hospitals, Insurance, Physicians, Regulatory

Contact Author

Share  | 

Newly Released Audit Protocol Serves as Guidance for Compliance Programs

The Health Information Technology for Economic and Clinical Health Act ("HITECH Act"), passed in 2009, imposed new requirements on health care providers (among others) related to the privacy and security of Protected Health Information ("PHI").  Included in the HITECH Act's requirements was a mandate that the Department of Health and Human Services’ ("HHS") Office for Civil Rights ("OCR") conduct audits to analyze the processes, controls and policies of certain covered entities.  The pilot program for such audits began in 2011 and will conclude in December, 2012. Read More ›

Categories: Compliance, HIPAA, HITECH Act, Hospitals, Physicians, Regulatory

Posted by: Mindi M. Johnson, John R. Taylor

  |  Contact Author

Share  |