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
After a tumultuous four days, Joe Biden crossed the electoral college threshold to become the 46th President of the United States, a result that the Trump Campaign is challenging with recounts and litigation in several...more
On May 15, the House of Representatives passed the Health and Economic Recovery Omnibus Emergency Solutions (Heroes) Act (H.R. 6800, as amended by a manager’s amendment) along mostly party lines (208–199). While Senate...more
Editor’s Note: In a new toolkit prepared for the Robert Wood Johnson Foundation, summarized below, Manatt Health helps insurance regulators understand the wide range of transparency and competition strategies available to...more
3/5/2020
/ Anti-Competitive ,
Antitrust Provisions ,
Benefit Plan Sponsors ,
Competition ,
Cost-Sharing ,
Department of Health and Human Services (HHS) ,
Department of Insurance ,
Drug Pricing ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Horizontal Mergers ,
Hospital Mergers ,
Medicaid ,
Medicare ,
Transparency ,
Vertical Mergers
Editor’s Note: Seeking methods to better understand and control healthcare costs, many states are taking a careful look at a state-defined spending target, or “benchmarking” model, that originated in Massachusetts and has...more
Editor’s Note: It’s welcome news that Department of Health & Human Services (HHS) Secretary Alex Azar has embraced the cause of transparency in healthcare. In a new Health Affairs blog post, summarized below, Manatt Health...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 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
Section 1332 Waivers: Will We See More State Innovation? -
Editor's Note: In a new essay for the National Institute of Health Care Management (NIHCM), summarized below, Manatt Health examines Section 1332 waivers and the...more
8/25/2016
/ 1332 Waiver ,
Assisted Suicide ,
Customer-Loyalty Programs ,
Department of Health and Human Services (HHS) ,
Discounts ,
Dispute Resolution ,
False Claims Act (FCA) ,
Federal Trade Commission (FTC) ,
Long Term Care Facilities ,
Medicaid ,
Off-Label Promotion ,
Patient Privacy Rights ,
PHRMA ,
Prescription Drug Coverage ,
Section 340B ,
Unfair or Deceptive Trade Practices
Massachusetts posted a draft 1332 waiver proposal for public comment on February 2, 2016. The waiver proposes to preserve certain features of the Commonwealth's current small group market, which was merged with the individual...more
Lessons from Hawaii's Trailblazing ACA 1332 Waiver Proposal -
Editor's Note: On September 9, Hawaii became the first state to post a draft 1332 waiver proposal for public comment. While Hawaii's proposal focuses on the...more
12/22/2015
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Contraceptive Coverage Mandate ,
Department of Health and Human Services (HHS) ,
Freedom of Religion ,
Hospital Mergers ,
IRS ,
Long-Term Care ,
Medicare ,
Medicare Part B ,
OIG ,
Prescription Drugs ,
Public Health Insurance Marketplace ,
SCOTUS ,
Section 340B ,
Split of Authority ,
Stark Law ,
Waivers
Overview -
On September 9 Hawaii became the first state to post a draft 1332 waiver proposal for public comment. While Hawaii's waiver proposal is focused on the state's unique 40-year-old employer mandate, the 40-page...more
9/28/2015
/ Affordable Care Act ,
Comment Period ,
Department of Health and Human Services (HHS) ,
Employee Retirement Income Security Act (ERISA) ,
Employer Mandates ,
Essential Health Benefits ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Individual Mandate ,
Public Health Insurance Marketplace ,
Scope of Coverage ,
SHOP Program ,
Tax Credits ,
U.S. Treasury ,
Waivers
Abstract -
States have long been the testing ground for new models of health care and coverage. Section 1332 of the Affordable Care Act, which takes effect in less than two years, throws open the door to innovation by...more
How Does the DOMA Defeat Impact Healthcare Reform and Health Insurance Access? -
NOTE: The Supreme Court's 5-4 decision to invalidate the Defense of Marriage Act (DOMA) will affect more than 1,000 federal statutes—and...more
7/16/2013
/ Affordable Care Act ,
Delays ,
Department of Health and Human Services (HHS) ,
DOMA ,
Employee Benefits ,
Employer Mandates ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Pay or Play ,
Pharmacies ,
Same-Sex Marriage ,
SCOTUS ,
Shared Responsibility Rule ,
U.S. Treasury