On July 11 the U.S. Department of Justice (DOJ) announced a new Task Force on Market Integrity and Consumer Fraud. The wide-ranging Task Force will be chaired by the Deputy Attorney General and work towards: [T]he investigation and prosecution of cases involving fraud on the government, the financial markets, and consumers, including cyber-fraud and other … Continue reading
On Saturday, July 7, 2018, the Centers for Medicare & Medicaid Services (CMS) announced the suspension of risk adjustment payments for the 2017 benefit year until the resolution of risk adjustment litigation following the decision in New Mexico Health Connections v. United States Department of Health and Human Services et al., in the United States … Continue reading
The United States Department of Labor (DOL) published a final rule on June 19 that relaxes the regulation of, and expands access to, association health plans (AHPs). President Donald J. Trump’s October 12, 2017 Executive Order instructed the DOL to consider expanding access to association health plans and the Department released a proposed rule on … Continue reading
In the absence of federal action, states have attempted to rein in high pharmaceutical pricing by enacting laws aimed at regulating drug pricing. Following what now has become a trend, on March 13, 2018, Oregon became the newest state to enact such legislation, The Prescription Drug Price Transparency Act, H.B. 4005. But many of these … Continue reading
As we previously reported, on February 9, the U.S. Senate and House of Representatives approved the Bipartisan Budget Act of 2018 (the “Act”) and President Trump subsequently signed the bill into law. Section 50404 of the Act includes several amendments to the Stark Law. Specifically, Section 50404 endorses recent liberalizations of the Stark Law requirements … Continue reading
Early this morning, Friday, February 9, the US Senate voted 71 – 28 to approve a budget proposal. Subsequently, the House of Representatives passed by a 240 – 186 vote the budget package and President Trump has signed the bill into law. The legislation reportedly: (i) funds federal agencies until March 23; (ii) includes US$89.3 … Continue reading
On January 5, 2018, the U.S. Food and Drug Administration (“FDA”) released guidance entitled Policy Regarding Certain Entities Subject to the Current Good Manufacturing Practice and Preventive Controls, Produce Safety, and/or Foreign Supplier Verification Programs: Guidance for Industry. The guidance states that FDA will exercise enforcement discretion for certain parts of the Food Safety Modernization … Continue reading
Pursuant to President Donald J. Trump’s October 12, 2017 Executive Order instructing the U.S. Department of Labor (DOL) to consider expanding access to association health plans (AHP), the DOL published a proposed rule on January 5, 2018 that would modify ERISA regulations to increase the availability of AHPs. Association health plans have been defined as … Continue reading
On December 2, the U.S. Senate passed a tax bill by a 51-49 vote. The legislation would not repeal the Affordable Care Act (ACA) individual health insurance mandate but instead would eliminate tax penalties for con-compliance with the mandate. Senator Susan Collins (R-ME) announced her support for the bill in a press release in which … Continue reading
On November 13, the American Hospital Association, Association of American Medical Colleges, America’s Essential Hospitals, Eastern Maine Healthcare Systems, Henry Ford Health System, and Fletcher Hospital filed a lawsuit in United States District Court for the District of Columbia seeking declaratory and injunctive relief, including a preliminary injunction preventing the reduction in payments for 340B … Continue reading
On October 12, President Trump announced in a filing by the Department of Justice in the ongoing litigation challenging the cost-sharing reduction (CSR) payments that such payments will no longer be made to insurers. CSR payments help offset deductibles and other out-of-pocket expenses for Affordable Health Care Act (ACA) exchange health insurance coverage for approximately … Continue reading
On August 15, the Congressional Budget Office (“CBO”) released a report on the effects of terminating payments to insurers for cost-sharing reductions under the Affordable Care Act (“ACA”) in 2017. The CBO estimated that by 2018, insurance premiums for silver plans would increase by 20 percent and leave 5 percent of Americans living in areas … Continue reading
On August 11, the Centers for Medicare & Medicaid Services sent a memorandum to insurers announcing an extension of the deadline by almost three weeks until September 5 for insurers to file their 2018 rate requests. Insurers are wrestling with whether to participate in the Affordable Care Act exchanges/marketplaces in 2018, and if so, the … Continue reading
On August 1, Chairman Lamar Alexander (R-Tenn.) and Ranking Minority Member Patty Murray (D-Wash.) of the U.S. Senate Committee on Health, Education, Labor and Pensions announced that the committee will hold hearings the week of September 4th on actions that Congress could take in an attempt to stabilize and strengthen the individual insurance markets in … Continue reading
Last week the U.S. Senate rejected three health care reform proposals intended to repeal all or parts of the Affordable Care Act (ACA). On Tuesday, Vice President Mike Pence cast the deciding vote 51-50 for the Senate to begin debate on legislation to repeal significant parts of the ACA. Later Tuesday evening, however, the Senate … Continue reading
On January 27, 2017, President Trump signed an executive order titled “Protection Of The Nation From Foreign Terrorist Entry Into The United States,” (EO) barring foreign nationals from Iraq, Iran, Libya, Somalia, Sudan, Syria and Yemen from entering the United States for 90 days, and if refugees, for 120 days except for Syrian refugees whose … Continue reading
Repeal and Replacement of the Patient Protection and Affordable Care Act (ACA) On January 12 and 13, 2017, the 115th Congress set the stage for the Trump administration by passing a budget resolution to repeal major provisions of the ACA with a simple majority vote. On January 27, 2017, President Trump signed an executive order … Continue reading
January 20, 2017 Memorandum from Reince Priebus On January 20, 2017, the White House issued a memorandum for the Heads of Executive Departments and Agencies. In the memorandum, Reince Priebus, Assistant to the President and Chief of Staff, provided a directive including the following: Do not send any regulations to the Office of the Federal … Continue reading
The “100 Day Action Plan” of President-elect Donald Trump promised to bring broad and sweeping change to the current laws governing the healthcare industry in the US Specifically, Trump’s 100 Day Action Plan called for the full repeal of the Patient Protection and Affordable Care Act (“ACA”) and its replacement with health savings accounts, cross-states … Continue reading