Updates by Reed Smith on U.S. legislative & regulatory developments affecting the health care industry
This post was also written by Marquan Robertson, a Reed Smith summer associate.
In 2019, the Department of Health and Human Services Office of Civil Rights (OCR) announced its Right of Access Initiative. The Right of Access Initiative realizes OCR’s commitment to ensuring the aggressive enforcement of patients’ rights to receive copies of their medical…
What would federal health policy look like under a Trump Administration? Donald Trump outlined his plan for “Healthcare Reform to Make America Great Again” on March 2, 2016. The heart of the plan is a call for Congress to repeal the Affordable Care Act (aka “Obamacare”) and enact other “free market” policies, including:
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On the Reed Smith Life Sciences Legal Update blog, Health Care team members Thomas Greeson and Paul Pitts have written about post-election implications for the radiology industry. The report describes their assessments of the short and mid-term time horizon for a number of health policy developments such as integration (e.g., accountable care organizations), government enforcement…
HHS has launched the State Innovation Models Initiative, a $275 million competitive funding opportunity for up to 30 states to design and test multi-payer payment and delivery models designed to generate savings and improve care for Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) beneficiaries. States can apply for either Model Testing awards, intended…
On July 26, CMS is hosting a webinar on the State Innovation Models Initiative, a competitive funding opportunity for states to design and test multi-payer payment and delivery models that deliver high-quality health care and improve health system performance.
Recent hearings on health policy issues include:
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HHS published a rule on February 27, 2012 that implements the procedural framework for submission and review of State Innovation Waiver applications under section 1332 of the ACA, effective April 27, 2012. Under the rule, states will have flexibility to apply for a State Innovation Waiver to pursue their own strategies to provide their…
CMS is launching a new Innovation Advisors program, which will provide fellowships to up to 200 individuals to test new models of care delivery in their own organizations and communities. CMS is seeking experts in health care economics and finance, population health, systems analysis, and operations research to support the Innovation Center in testing new…
CMS and the HHS Office of the National Coordinator are hosting the first “Care Innovations Summit” in Washington, DC on January 26, 2012 to “showcase innovative work in care delivery and payment.” Presentations will be delivered by “national thought leaders, senior government officials and visionary innovators,” who will provide information on opportunities for collaboration, funding,…
The House of Representatives has voted to repeal the ACA, by a largely party-line vote of 245 to 189. The House subsequently passed H. Res. 9, to instruct four House committees (Education and the Workforce, Energy and Commerce, Judiciary, and Ways and Means) to report legislation to replace the law with provisions that achieve a …
The new Republican leadership of the House of Representatives are moving ahead on legislation (H.R. 2) to repeal the Patient Protection and Affordable Care Act and the health care-related provisions in the Health Care and Education Reconciliation Act of 2010 (collectively known as the ACA). On January 7, the House approved a procedural motion to…
As widely reported in the media, on October 14, 2010, a federal judge in Florida ruled that he will allow a lawsuit challenging the constitutionality of the Affordable Care Act to proceed. The lawsuit argues that the ACA’s individual mandate that people buy health insurance or else pay a penalty exceeds Congress’s authority under the…
On July 23, 2010, the Obama Administration published an interim final rule with comment period implementing ACA requirements regarding internal claims and appeals and external review processes for group health plans and health insurance coverage in the group and individual markets. The rules generally apply to plan/policy years beginning on or after September 23, 2010.…
On June 28, 2010, the Obama Administration published an interim final rule with comment period implementing Affordable Care Act insurance reforms it dubs “a new Patient’s Bill of Rights.” Specifically, the regulation issued by the Departments of Health and Human Services (HHS), Labor, and Treasury implements ACA provisions regarding preexisting condition exclusions, lifetime and…
On June 29, 2010, the HHS Office of Consumer Information and Insurance Oversight (OCIIO) announced that it is now accepting applications for the Early Retiree Reinsurance Program (EERP), a $5 billion program established by the Affordable Care Act. The EERP will reimburse participating employment-based plans for a portion of the cost of health benefits for…
On July 1, 2010, HHS announced the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been uninsured for at least six months, have been unable to get health coverage because of a health condition, and are a U.S. citizen or are residing in the U.S.…
Suppliers and manufacturers of durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) will be impacted, directly and indirectly, by numerous provisions of the recently-enacted health reform legislation, H.R. 3590, the Patient Protection and Affordable Care Act (PPACA), as amended by H.R. 4872, the Health Care and Education Reconciliation Act of 2010 (Reconciliation Act), collectively known as the “Affordable Care Act” or ACA.
Continue Reading Reed Smith Health Care Reform Review: The Affordable Care Act – Analysis and Implications for DMEPOS Suppliers
Under the ACA, certain group health plans and health insurance coverage existing as of March 23, 2010 (the date of enactment of the ACA), are considered “grandfathered” and excused from complying with some of the ACA’s health care improvement and market reform provisions. On June 17, 2010, the Department of Health and Human Services (HHS)…
The ACA provides a tax-free, one-time $250 check for beneficiaries who reach the Part D coverage gap during 2010 and are not eligible for low-income subsidies. A June 10, 2010 CMS memo to Part D plan sponsors provides additional information on implementation of coverage gap rebate. The memo notes that prompt submission of prescription drug…
In April 2010, Reed Smith provided an extensive analysis of the recently-enacted health reform legislation, H.R. 3590, the Patient Protection and Affordable Care Act (PPACA), as amended by H.R. 4872, the Health Care and Education Reconciliation Act of 2010 (Reconciliation Act). Together, these sweeping measures expand access to health insurance (including subsidies, mandates, and market reforms); reduce health care spending (particularly in the Medicare program); expand federal fraud and abuse authorities and transparency requirements; impose new taxes and fees on health industry sectors; and institute a variety of other health policy reforms.
Continue Reading Reed Smith Health Care Reform Review: Analysis and Implications of Fraud Abuse and Program Integrity Provisions of the Affordable Care Act
