U.S. Supreme Court Denies Review of Another ACA Individual Mandate Challenge

 

On January 12, 2015, the U.S. Supreme Court refused to review a D.C Circuit case challenging the Affordable Care Act’s (ACA’s) individual mandate. See, ASSOCIATION of AM. PHYSICIANS & SURGEONS v. BURWELL, No. 14-350 (U.S. REVIEW DENIED JAN. 12, 2015). [More]

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U.S. Supreme Court Will Hear Oral Arguments in ACA Subsidy Case on March 4, 2015

 

On December 22, 2014, the U.S. Supreme Court announced that it will hear oral arguments in KING v. BURWELL, No. 14-114, in the case challenging the position that subsidies under the Affordable Care Act (ACA) are permitted in states with federally facilitated marketplaces as well as in states with state-based marketplaces. [More]

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Human Services Legislation in the 114th Congress

 

The 114th Congress was sworn in January 5, 2015 and will be in place until January 8, 2017. During this time, multiple bills and resolutions will be brought forward for discussion, hearings, and debate, possibly eventually becoming law. If the 114th follows in the tradition of the 113th there will be relatively few bills passed this year. Only 297 bills were passed and made into law during the 113th Congress – the lowest number since the Congress of 1947. [More]

 

CMMI Announces $666 Million in State Health Care Innovation Awards

 

The U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (CMMI) announced on December 16, 2014 that it is authorizing $623 million in “model testing” awards to 11 states and $43 million in “model design” awards to 17 states, three territories, and the District of Columbia. CMMI has approved the awards under section 3021 of the Affordable Care Act (ACA). These “model testing” and “model design” awards complete “round two” in CMMI’s State Innovation Models (SIM) initiative. [More]

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CMS Proposes Changes in Medicare ACO Rules

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) published proposed rules in the December 8, 2014 Federal Register on accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) under section 3022 of the Affordable Care Act (ACA). Under the MSSP, Medicare providers and suppliers that participate in a qualifying ACO receive traditional Medicare Part A and Part B fee-for-service payments, the ACO drives collaboration, and the ACO has an opportunity to earn “shared savings” bonus payments for each ACO “performance period” if it achieves MSSP savings targets and performance standards under quality measures for that period. [More]

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D.C. Circuit Decides Not to Proceed with En Banc Review of ACA Subsidies Case Pending U.S. Supreme Court Decision in KING V. BURWELL

 

On November 10, 2014, the D.C Circuit Court of Appeals agreed not to proceed with its en banc review of HALBIG v. BURWELL, 758 F.3d 390 (D.C. Cir. 2014), which had held that subsidies provided for under the Affordable Care Act (ACA) were to be restricted to states which opted to establish their own Health Benefit Exchanges. [More]

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US Supreme Court to Review ACA Tax Credit Authority

 

The U.S. Supreme Court announced on November 7, 2014 that it will review King v. Burwell, in which the U.S. Court of Appeals for the Fourth Circuit upheld an Internal Revenue Service regulation allowing advance premium tax credits (APTCs) for low-income individuals and families enrolling in qualified health plans (QHPs) through “Federally-facilitated Exchanges (FFEs).” [More]

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CMS Issues Proposed Notice to Establish Methodology to Determine Federal Payments Under BHP in 2016

 

The Centers for Medicare & Medicaid Services (CMS) published in the October 23, 2014 Federal Register a proposed Notice (79 Fed. Reg. 63363) which would establish the methodology the agency intends to utilize to determine federal payments under the Basic Health Program (BHP) in 2016. Pursuant to Section 1331 of the Affordable Care Act (ACA), states can elect to operate a BHP, which would provide affordable health coverage to individuals under age 65 with household incomes between 133% and 200% of the federal poverty level who are not otherwise eligible for Medicaid, CHIP, or affordable employer-sponsored coverage. [More]

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HHS Report Updates ACA Impact on Medicaid Enrollments

 

The U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), released on October 17, 2014 a report showing that 26 jurisdictions (25 states and the District of Columbia) which implemented Medicaid expansion under the Affordable Care Act (ACA) by August 2014 saw on average a 22.09 percent increase in Medicaid/CHIP enrollments for August 2014, as compared to their average monthly enrollments in a July – September 2013 baseline period. [More]

 

OK Federal District Court Judge Issues Adverse Decision in ACA Tax Credit Controversy

 

On September 30, 2014, Judge Ronald White of the U.S. District Court for the Eastern District of Oklahoma ruled that language in the Affordable Care Act (ACA) rendered invalid an IRS regulation that authorizes tax credits in federal exchanges as well as state exchanges. [More]

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