Patient Protection and Affordable Care Act (PPACA)

CMS has announced that it is hosting monthly conference calls on ACA implementation efforts that impact doctors, nurses, hospitals and other health care providers. These calls will be held on the second Thursday of the month, and will review recent HHS announcements, focus on select topics, and provide an opportunity for public feedback. 

The first

With all attention now focused on the campaign for control of Congress and the Presidency, it might be easy to forget that the 112th Congress is still in session and returns to work in September. When Congress does return, a number of important decisions affecting health care and energy policy, among other areas, remain to be considered.
Continue Reading Jumping Off The ‘Fiscal Cliff’? What Can Happen When Congress Returns?

The Internal Revenue Service (IRS) is holding a November 9, 2012 public hearing on the ACA’s branded prescription drug fee.  The subject of the hearing will be the agency’s August 18, 2011 notice of proposed rulemaking that cross-referenced temporary regulations also issued on August 18.  The IRS must receive outlines of topics to be discussed at

On June 20, 2012, HHS is publishing a final rule to implement the first phase of a process to recognize accrediting entities that will certify qualified health plans for participation in ACA Affordable Insurance Exchanges. In phase one, HHS is recognizing the National Committee for Quality Assurance and URAC as accrediting entities on an

On July 11, 2012, the House of Representatives took a largely symbolic vote on H.R. 6079, a bill to repeal the ACA. Even if the Senate considers the legislation, which is highly unlikely, the White House opposes enactment of the bill.

Congressional panels have examined a number of health policy issues recently, including:

  • ACA Hearings: The House Ways and Means Committee held a hearing on the implications of the Supreme Court’s ruling that the individual mandate in the ACA is constitutional, particularly as it relates to Congress’ taxing authority.  The House Oversight and Government Reform

As drug and device manufacturers continue to await final federal rules implementing the Affordable Care Act’s Physician Payment Sunshine Act (“Sunshine Act”) provisions, Massachusetts has relaxed its similar state law banning the provision by manufacturers of gifts to health care practitioners (HCPs) and requiring disclosure of payments and transfers of value to HCPs. The revisions

This post was also written by Tillman J. Breckenridge. As has been widely reported, today the U.S. Supreme Court ruled that the Affordable Care Act’s (ACA) individual health insurance mandate does not violate the Constitution because it may be viewed as a permissible tax on individuals who do not obtain health insurance.  The only provision of the law that the Court invalidated is a Medicaid provision that threatened states with the loss of existing Medicaid funding if they decline to comply with the ACA’s Medicaid coverage extension. By preserving the vast majority of the landmark health reform law, the Court avoided the policy chaos that would have resulted from striking down the ACA in its entirety. There is now legal certainty for state and federal governments, health care providers and suppliers, drug and device manufacturers, employers and individuals.  As discussed below, the focus in Washington will return to continuing implementation of the law. Nevertheless, although the legal battle is over, the political fight will continue and likely reverberate through the coming Presidential and Congressional election campaigns.
Continue Reading Supreme Court Upholds ACA Insurance Mandate, Limits Withholding of Medicaid Funds to States

On June 26, 2012, the Internal Revenue Service (IRS) published proposed regulations implementing ACA requirements for charitable hospitals relating to financial assistance and emergency medical care policies, charges for certain care provided to individuals eligible for financial assistance, and billing and collections. Note that the proposed regulations do not address the ACA’s community health needs

On June 5, 2012, the Department of Health and Human Services (HHS) published a proposed rule that would implement the first phase of a process to recognize accrediting entities that will certify qualified health plans for participation in ACA Affordable Insurance Exchanges. In phase one, HHS proposes to recognize the National Committee for Quality

Through the Advance Payment Accountable Care Organization (ACO) initiative, CMS is testing the extent to which pre-paying a portion of future shared saving could increase participation in CMS’s Medicare Shared Savings Program (MSSP). While CMS previously announced that applications would only be accepted for April 1, 2012 and July 1, 2012 start dates, CMS now