On February 11, the U.S. Court of Appeals for the Seventh Circuit ruled that consultants who provide services to nursing homes and long-term care facilities lack standing to sue the state Medicaid agency and its contracted Managed Care Organizations on behalf of patients.
In Bria Health Servs., LLC v. Eagleson, No. 18-3076 (7th Cir.
On Tuesday, February 20, Department of Health and Human Services (HHS) Secretary Alex Azar announced that the agency intends to expand access to short-term, low-cost insurance policies. On Wednesday, HHS published its proposed rule, which promises to reduce restrictions on such limited-duration policies. The short-term insurance plans have fewer benefits and more limited consumer protections as compared to those proscribed by the Patient Protection and Affordable Care Act (ACA). While such short-term plans currently can only be carried for 90 days, the new proposal would extend that maximum coverage period to one year.
The proposed rule is in response to President Trump’s Executive Order from October 12, 2017, which called for HHS to expand access to low-cost insurance plans. The Executive Order asked the agency to explore the possibility of extending the maximum duration of such short-term, limited-duration plans in order to increase options for consumers. The short-term insurance plans are contemplated for individuals who are unemployed, between jobs, or otherwise looking to reduce premium costs for up to one year. The plans do not have to meet ACA requirements. Notably, they do not have to cover individuals with pre-existing conditions and they do not have to cover prescription drug plans. The plans offer more limited coverage for consumers, but impose less immediate financial burden through reduced premium cost. Insurers who sell the short-term plans would need to include clear statements on applications and plan documents that the coverage does not meet ACA requirements.
The proposed rule continues the Trump administration’s efforts to roll back the ACA and minimize its economic burden and comes just over a year after the president issued an Executive Order laying out that goal. It comes on the heels of earlier rules from the administration geared at stabilizing the individual and small group insurance markets. It also follows the signing of the new tax reform bill, which repeals the individual mandate of Section 5000A of the Tax Code and eliminates the shared responsibility payment for failure to obtain health insurance starting in 2019.Continue Reading Azar Rolls Out Expansion of Short-Term, Limited-Duration Insurance Plans
Health insurers will be expected to establish security protocols for protecting consumer information from data breaches. The National Association of Insurance Commissioners recently adopted principles to guide both insurers’ data protection activities and data breach notification policies, and regulatory oversight of those practices.
Click to read more on Crowell & Moring’s Data Law Insights blog
Crowell & Moring’s 31st annual Ounce of Prevention Seminar (OOPS) will take place in Washington, D.C. from May 5-6 and in Marina del Rey, CA on May 14. This year’s seminar, “White House v. Congress: Government Contractors Bracing for the Showdown in Washington,” will cover an array of policies and legislation that will have sweeping
Crowell & Morning invites you to join us for a half-day of discussions regarding four significant topics affecting the long term care industry. Members of C&M’s Government Affairs and Health Care groups, along with featured speakers from Capitol Hill, federal agencies and trade groups, will lead sessions providing important updates on:
Earlier this week, the Supreme Court heard arguments in a case that could determine whether federal regulators may revise established interpretations of rules without first complying with the notice-and-comment rulemaking process required by the Administrative Procedure Act. Although the specific case before the Court (Perez v. MBA) involves a Department of Labor rule, a decision
This year Crowell & Moring’s Healthcare Ounce of Prevention Seminar, (HOOPS), will focus on important legal and regulatory developments and their impact on the healthcare industry. Join us on October 27th and October 28th in Washington, DC as our healthcare attorneys and outside speakers share their perspectives on the latest developments in areas of interest
Managed Care Lawsuit Watch is Crowell & Moring’s summary of key litigation affecting managed care. The latest issue covers a broad range of lawsuits, including: Medicare’s preemption of state common law negligence claims; arbitration clauses in provider agreements; the right of a Medicare Advantage plan to assert a lien on a deceased beneficiary’s negligence settlement;
On March 20-21, 2014, the Federal Trade Commission (FTC) held a public workshop, “Examining Health Care Competition,” to discuss trends and developments in the health care industry that may affect competition. Specifically, the workshop used five panels of industry participants and experts to study professional regulation of health care providers, innovations in health care delivery,
On February 10, 2014, the Centers for Medicare & Medicaid Services (CMS) published a notice seeking public comment on its revision to data elements being collected for coverage offered on and off the Exchange. In particular, CMS seeks comment on revisions to data collected by the Exchange to ensure that Qualified Health Plans meet certain