The Affordable Care Act (ACA) Marketplaces have nearly tripled their enrollment in their first decade of operation, from eight million people in 2014 to 21.4 million in 2024. At the national level, the ACA has helped cut the...more
On April 5, President Biden held an event at the White House celebrating coverage gains since the enactment of the Affordable Care Act (ACA). Joined by Vice President Harris and former President Obama, President Biden...more
In a new “Expert Perspective” prepared for the Robert Wood Johnson Foundation’s State Health and Value Strategies program, Manatt Health provides a midyear update on the public option at the federal and state levels. ...more
In a new report prepared in partnership with the Leukemia & Lymphoma Society (LLS), summarized below, Manatt Health reviews policy challenges that may hamper patients’ ability to navigate and obtain proper treatment for their...more
The Big Picture -
The Biden Administration is just two weeks old, and President Biden has already issued more than two dozen Executive Orders on racial justice, health equity, strengthening Medicaid and the Affordable...more
Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of...more
Technological innovation has always been at the center of the Affordable Care Act (ACA) Marketplaces and has never been more important than it is now. Changes brought on by the coronavirus pandemic have clearly illustrated a...more
Examine the Evolving Challenges That Lie Ahead for Healthcare Stakeholders and State Regulators—and What You Can Do Now to Prepare and Protect Your Organization—at a New Manatt Webinar.
Effective health insurance...more
4/10/2020
/ Affordable Care Act ,
Appeals ,
Audits ,
Billing ,
Compliance ,
Coronavirus/COVID-19 ,
Cost-Sharing ,
Employee Retirement Income Security Act (ERISA) ,
Enrollment ,
Extensions ,
Grace Period ,
Health Claims ,
Health Insurance ,
Healthcare Costs ,
Medical Testing ,
Out of Network Provider ,
Preemption ,
Premiums ,
Reporting Requirements ,
Risk Adjustment Formula ,
Risk-Based Approaches ,
Scope of Coverage ,
Stakeholder Engagement ,
State Regulators ,
Tax Credits ,
Utilization Review ,
Waivers ,
Webinars
On November 4, Georgia released two draft waiver applications for public comment—a Section 1332 State Relief and Empowerment Waiver (“1332 waiver”) to restructure the state’s individual insurance market and a Section 1115...more
In late March, the Centers for Medicare & Medicaid Services (CMS) released its Marketplace open enrollment report showing that 11.4 million people selected Affordable Care Act (ACA) Marketplace plans in 2019—a 4% decline in...more
Editor’s Note: While Democratic victories in the U.S. House have fueled national conversations about some variant of Medicare for all, most of the policy change in the near term is likely to continue to be at the state level....more
Mental Health and Minors: Proceed With Caution! -
Imagine representing a party in a lawsuit concerning coverage for mental health services. The lawsuit was brought by the parents of a minor child. The client received a...more
With Congress failing to reach agreement on a stabilization package for the individual market and repeal of the individual mandate set to take effect for 2019, states are considering different strategies, some that will...more
The Affordable Care Act was designed in part to help bring stability to the individual health insurance market. But faced with a fluid federal regulatory environment, many states continue to encounter challenges, including...more
1332 Waivers Under Review at CMS -
The Trump administration has approved one 1332 waiver to date, but four more are pending, including a sweeping Iowa waiver. Here is where things stand today...more
On July 11, the federal government announced approval of Alaska’s waiver request under Section 1332 of the Patient Protection and Affordable Care Act for funding in support of the Alaska Reinsurance Program (ARP). The ARP is...more
Overview -
On June 12, Iowa submitted a sweeping Section 1332 waiver that would replace the Affordable Care Act’s (ACA) premium tax credits with a new state-administered tax credit and a reinsurance program. The state tax...more
Mapping the Healthcare M&A Landscape Under the New Administration -
Editor’s Note: The healthcare M&A market continues to be among the most active sectors. In a recent webinar, Manatt examined how the policies and goals of...more
5/25/2017
/ Acquisitions ,
Affordable Care Act ,
American Health Care Act (AHCA) ,
Antitrust Provisions ,
Centers for Medicare & Medicaid Services (CMS) ,
DSH ,
Food and Drug Administration (FDA) ,
Health Insurance ,
Healthcare Reform ,
Hospitals ,
Mergers ,
Trump Administration
CMS Issues Self-Referral Disclosure Protocol for Stark Law Violations -
On March 28, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a new voluntary self-referral disclosure protocol (SRDP) for disclosing...more
4/25/2017
/ Affordable Care Act ,
Anti-Steering Rules ,
Antitrust Provisions ,
Centers for Medicare & Medicaid Services (CMS) ,
Deceptive Intent ,
Department of Justice (DOJ) ,
Drug Pricing ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmacist ,
Self-Referral ,
Stark Law ,
Telehealth ,
Trump Administration
Editor's Note: In a dramatic conclusion to the heated debate surrounding the American Health Care Act (AHCA), the bill was withdrawn after it became clear that House leadership did not have enough votes to pass it. There is...more
4/25/2017
/ Administrative Authority ,
Affordable Care Act ,
Discrimination ,
Executive Orders ,
Gender Identity ,
Health Care Providers ,
Health Insurance ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Pharmaceutical Industry ,
Pregnancy Discrimination ,
Section 1557 ,
Trump Administration
The Future of Essential Health Benefits -
Editor's Note: The Essential Health Benefits (EHB) rule may be among the many parts of the Affordable Care Act (ACA) that are on the chopping block as the Trump Administration and...more
3/24/2017
/ Affordable Care Act ,
Antitrust Immunity ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Essential Health Benefits ,
False Claims Act (FCA) ,
Health Insurance ,
Healthcare Reform ,
Insurer Liability ,
Medicaid ,
Premiums ,
Repeal ,
Trump Administration
As the incoming Congress and administration develop plans to “repeal and replace” the Affordable Care Act (ACA), analysis of five earlier repeal and replace proposals provides insights into the key features likely to appear...more
Post-Election Analysis: Healthcare Antitrust in a Trump Administration -
In a Republican sweep of all the elected branches of the federal government, Donald Trump won the presidential election and Republicans retained...more
11/23/2016
/ Affordable Care Act ,
Alternative Payment Models (APM) ,
Centers for Medicare & Medicaid Services (CMS) ,
Covered Entities ,
Data Collection ,
Data Security ,
Enforcement ,
Federal Trade Commission (FTC) ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Healthcare Reform ,
Internal Revenue Code (IRC) ,
IRS ,
Marketing ,
Medicare Access and CHIP Reauthorization (MACRA) ,
MIPS ,
Presidential Elections ,
Public Concern ,
Reinsurance ,
Section 501r ,
Trump Administration
The Election’s Impact on Healthcare: Preparing for Potential Scenarios -
Editor’s Note: Election 2016 will have a major impact on federal and state healthcare policy. To be prepared for all the possibilities, it’s...more
9/22/2016
/ Affordable Care Act ,
Civil Monetary Penalty ,
Department of Justice (DOJ) ,
False Claims Act (FCA) ,
FCC ,
Federal Trade Commission (FTC) ,
Health Care Providers ,
Health Insurance Portability and Accountability Act (HIPAA) ,
IPAB ,
Presidential Elections ,
Privacy Policy ,
Risk Mitigation ,
TCPA ,
Telemarketing ,
WhatsApp
Liberating Data to Enable Healthcare Market Transparency: A Guide for Regulators and Policymakers -
Editor's Note: We are on the cusp of a transparency revolution in which consumers will have the data and tools to make...more