I wrote the January 2013 edition of Take 5: Views You Can Use, a newsletter published by the Labor and Employment practice of Epstein Becker Green.
In it, I summarize five actions that employers should consider taking in 2013 as the DOL steps up its audit efforts under the leadership of the reenergized Obama administration:
- Assess the Workforce
- Choose Whether to “Pay” or to “Play”
- Evaluate Existing Wellness Programs and/or Implement New Wellness Programs to Enhance Employees’ Health Profiles and to Avoid or Minimize the “Cadillac Tax”
- Understand and ...
Please join Epstein Becker Green’s Health Care & Life Sciences and Labor & Employment practitioners for a discussion of the recently released Employer Wellness Program regulations.
The Affordable Care Act created new incentives to promote employer wellness programs and encourage opportunities to support healthier workplaces. As such, HHS, DOL, and Treasury recently released proposed regulations increasing the amount of incentive a group health plan may offer a participant for participation in certain wellness programs
During this program, Epstein Becker Green ...
On May 16, 2012, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (“CMS”) published regulations announcing various changes to the Medicare Conditions of Participation (“CoP”) applicable to hospitals. According to the regulatory preamble, these revisions responded directly to the President’s “Executive Order 13563, by reducing outmoded or unnecessarily burdensome rules, and thereby increasing the ability of hospitals and [critical access hospitals] to devote resources to providing high quality patient care.” ...
Written by: Kara M. Maciel and Adam C. Solander
While some employers may have been disappointed with the U.S. Supreme Court’s recent decision affirming the constitutionality of the Patient Protection and Affordable Care Act (“PPACA”), there may be a silver lining to the seemingly dark cloud. By virtue of upholding PPACA, the Supreme Court also upheld Section 2705 of PPACA, the provision of the law that will allow employers to provide their employees incentives, up to 30 percent of their premiums, in return for participation in an employer-sponsored wellness program. ...
Stuart Gerson, a Member of the Firm in the Litigation and Health Care and Life Sciences practices at Epstein Becker Green, authored an article titled "The Supreme Court Has Decided, but Can America Afford the Affordable Care Act?"
Following is an excerpt:
By now, every American who pays any attention to the news is aware that on the last day of its now concluded term, the U.S. Supreme Court, with its June 28 decision in National Federation of Independent Business v. Sebelius, U.S., No. 11-393, 6/28/12, has upheld essentially all of the Obama Administration's Affordable Care Act (ACA ...
On Monday, July 2, 2012, Epstein Becker Green conducted a webinar titled "Decision 2012: What's In, What's Out, and What's Next?" examining the monumental decision (PDF) issued by the Supreme Court of the United States on the Patient Protection and Affordable Care Act.
This webinar analyzed the decision and its implications for the states, the health care and life sciences industry, and employers. It also addressed potential congressional activity and the decision's impact on the presidential election.
On Monday, July 2, 2012, Epstein Becker Green conducted a webinar titled "Decision 2012: What's In, What's Out, and What's Next?" examining the monumental decision (PDF) issued by the Supreme Court of the United States on the Patient Protection and Affordable Care Act.
This webinar analyzed the decision and its implications for the states, the health care and life sciences industry, and employers. It also addressed potential congressional activity and the decision's impact on the presidential election.
By now, every American who pays any attention to the news is aware that the Supreme Court of the United States has upheld essentially all of the Obama administration's Affordable Care Act. We have posted a copy of the lengthy opinion, concurrence, and dissent on our website. For now, we should be focusing on what the case of National Federation of Independent Business v. Sebelius actually will cause to occur.
by Jay Gerzog, Dale Van Demark, Tamar Rosenberg, and Dawn Welch
Is it possible that the U.S. Department of the Treasury (“Treasury”) knows something we do not about the pending U.S. Supreme Court decision on PPACA?
Probably not, but that has not stopped the Treasury and Internal Revenue Service (“IRS”) from issuing proposed regulations on June 26, 2012, with respect to three of the four new requirements for tax exemption of hospitals imposed by PPACA.
With the adoption of PPACA, Congress took its first concrete step toward toughening the standard for tax exemption in decades ...
In May 2012, the Employee Benefit Research Institute (“EBRI”) issued a report showing that the percentage of workers covered by employer-sponsored health care coverage (measured through April 2011) continued to fall despite improvement in the economy. Employer-sponsored health care coverage is the most common source of health care coverage for workers who exceed the poverty line and who are not yet eligible for Medicare. It covers approximately 69% of workers, 46% of non-working adults and 55% of children.
The EBRI report notes that there is a generally recognized link ...
On March 26, 27 and 28, 2012, the Justices of the Supreme Court of the United States (“SCOTUS”) heard oral arguments in a series of cases, including Department of Health and Human Services, et al. v. State of Florida, et al, which addresses the constitutionality of certain provisions of the Patient Protection and Affordable Care Act of 2010 (“PPACA”). In the three days of testimony, SCOTUS debated whether (1) the Anti-Injunction Act bars a decision until a tax is actually collected under PPACA, (2) the individual mandate to buy health insurance under PPACA is a valid exercise of ...
Written by: Stuart M. Gerson
The three days of arguments about the constitutionality of the Patient Protection and Affordable Care Act are complete. The Justices of the Supreme Court of the United States have conducted their post-argument conference and are now turning their attention to the drafting and the discussions that will lead to a majority opinion and, likely, several dissents and concurrences. The Court's decision should be issued before the end of June. Health care companies and employers, like the rest of the population, await the ultimate decision. However, there ...
by Jesse M. Caplan and Serra J. Schlanger
Since November 2011 the Center for Consumer Information & Insurance Oversight (“CCIIO”) in the Centers for Medicare & Medicaid Services has completed 22 reviews of health insurance premium rate increase filings in the individual and small group markets. Under the new federal rate review regulations, CCIIO has determined that six of the reviewed premium rate increases represented “unreasonable” increases while 16 of the rate increases were deemed “not unreasonable.”
This Implementing Health and Insurance Reform alert ...
On December 6, 2011, the U.S. Department of Labor (“DOL”) issued a proposed rule on Form M-1 filing requirements, a proposed rule on DOL ex parte cease and desist orders, a notice of proposed form revision to Form M-1 and a notice of proposed form revision to Form 5500 implementing new requirements for multiple employer welfare arrangements (“MEWAs”) under the Patient Protection and Affordable Care Act (“PPACA”) (referred to as the “Proposed Rules”). PPACA prohibits false statements or representations of fact about a MEWA’s financial condition ...
by Gretchen Harders, Daly D.E. Temchine, and Joseph J. Kempf, Jr.
On December 7, 2011, final rules on the medical loss ratio (“MLR”) requirements for insured health plans (and an interim final rule for non-federal governmental plans) were issued by the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services under the Patient Protection and Affordable Care Act. The MLR requirements are effective January 1, 2012, and any issuer who does not meet the MLR requirements for the 2011 MLR reporting year must pay rebates by August 1, 2012. This alert ...
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