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Featured Industry: Health Care
Spotlight on Best Practices, Litigation, Antitrust, and Tax for Health Care Companies

Crowell & Moring LLP is pleased to release its “2016 Litigation & Regulatory Forecasts: What Corporate Counsel Need to Know for the Coming Year.” The reports examine the trends and developments that will impact health care companies and other corporations in the coming year—from the last year of the Obama administration to how corporate litigation strategy is transforming from the inside out. This year will bring remarkable change for companies, as market disruptions and the speed of innovation transform industries like never before, and the litigation and regulatory environments in which they operate are keeping pace.Continue Reading Crowell & Moring’s 2016 Litigation & Regulatory Forecasts: What Corporate Counsel Need to Know for the Coming Year

On January 7, 2016, the HHS Office for Civil Rights released guidance on individuals’ right to access health information under the HIPAA Privacy Rule. The guidance clarifies areas of confusion and non-compliance by covered entities and business associates, particularly in light of the proliferation of electronic health records and electronic health information. Areas of emphasis …

The recent appropriations law, which will fund the federal government through 2016, suspends three health care taxes enacted under the Affordable Care Act, continues to limit how the Centers for Medicare & Medicaid Services can fund the temporary risk corridors program for the exchanges, and refines Medicare and Medicaid payments and funding. Click here for…

Our colleagues at Data Law Insights have written about the HHS Office of Civil Rights’ $750,000 settlement with the University of Washington Medicine (“UWM”) announced this week.  This third settlement in as many weeks confirms that the security risk analysis continues to be a linchpin of OCR enforcement under the HIPAA Security Rule.  Indeed, the …

The Department of Health and Human Services’ (HHS) proposed rulemaking for Section 1557 of the Affordable Care Act may vastly expand the reach of federal anti-discrimination laws into uncharted—and potentially unsupported—territory. Published on September 8, 2015, the proposed rule inspired thousands of comments from health insurers, advocacy groups, and individuals alike. Click here to read …

Beginning January 1, 2016, the Federal Employees Health Benefits Program (FEHBP) will include a self plus one enrollment option for its members. For 2015 and previous years, federal employees and annuitants enrolling in FEHBP plans had only two options, self only or self and family. The change was initially mandated by the 2013 Bipartisan Budget Act, and the U.S. Office of Personnel Management (OPM) published regulations on September 17, 2015 finalizing implementation of the self plus one enrollment type.

The new self plus one option will allow FEHBP members with one eligible dependent to enroll in a potentially less-expensive plan option than self and family. The rule does not impact eligibility for FEHBP benefits, either for employees and annuitants or for dependents, nor does it generally change the processes for members to enroll in coverage or modify coverage during the year. Premium conversion members—that is, FEHBP members whose shares of premiums are paid with pre-tax dollars, including most active employees—may enroll and change enrollment either during the open season in November and December of each year or upon the occurrence of a Qualifying Life Event (QLE). Like newly enrolling or changing from one plan to another, switching a covered family member will be permitted only during open enrollment or following a QLE. In addition to during open season and after QLEs, non-premium conversion members, including annuitants, may decrease enrollment type at any time by moving from self and family to self plus one or self only or from self plus one to self only. To address the novelty of the self plus one enrollment type and mitigate the effects of member confusion, in early 2016, OPM will allow a special “limited enrollment period” that will allow premium conversion members to decrease coverage from self and family to self plus one.Continue Reading OPM Finalizes Regulations Implementing Self Plus One Enrollment Type for FEHBP and Addresses Carriers’ Cost Concerns

On September 8, 2015, the Department of Health and Human Services Office for Civil Rights promulgated proposed regulations implementing Affordable Care Act Section 1557’s anti-discrimination provisions. Section 1557 applies federal anti-discrimination laws that prohibit discrimination based on race, color and national origin, sex, disability, and age to health care programs that receive federal funds, such …

The Food and Drug Administration’s (FDA) March 2015 approval of Zarxio, the first biosimilar product licensed under the Biologics Price Competition and Innovation Act of 2009 (BPIA) is expected to usher in a new wave of faster approvals, greater choice, and lower costs for the biologics market. Along with these exciting opportunities, however, come a …

The Centers for Medicare & Medicaid Services (CMS) recently sent a letter to state insurance commissioners, available here, setting forth five findings for departments of insurance to consider as they render final decisions on health insurance rates. The letter’s findings discuss cost and utilization trends as well as policy matters.

First, CMS notes that …