The U.S. Supreme Court decision in Maine Community Health Options v. United States, is a major decision affecting healthcare and resolving a significant Obamacare dispute. The Affordable Care Act famously established online...more
4/30/2020
/ Affordable Care Act ,
Appropriations Bill ,
Court of Federal Claims ,
Damages ,
Government Payments ,
Health Insurance ,
Insurance Industry ,
Maine Community Health Options v. United States ,
Reimbursements ,
Remand ,
Risk Corridors Statute ,
SCOTUS ,
Tucker Act
On June 3, 2019, the U.S. Supreme Court ruled in Azar v. Allina Health Services that the Medicare statute requires the Centers for Medicare & Medicaid Services (“CMS”) to engage in public notice-and-comment rulemaking...more
6/5/2019
/ Administrative Procedure Act ,
Azar v Allina Health Services ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Hospitals ,
Low-Income Issues ,
Medicare ,
Medicare Advantage ,
Medicare Part A ,
Medicare Part C ,
Notice and Comment ,
Pay Reductions ,
Provider Payments ,
Reaffirmation ,
Retroactive Application ,
SCOTUS ,
Substantive Rule ,
Vacated
News of two distantly related reimbursement issues with administrative law and False Claims Act (“FCA”) implications is worth noting....more
On June 16, 2016, the Supreme Court of the United States rendered a unanimous decision in the highly anticipated False Claims Act (“FCA”) case of Universal Health Services, Inc. v. United States ex rel. Escobar.[1] In its...more
On March 31, 2015, a 5-4 plurality of the Supreme Court of the United States ruled that Medicaid providers do not have a private right of action under the Medicaid statute to challenge reimbursement rates. The Supreme Court’s...more
On February 25, 2015, the Supreme Court of the United States held that the North Carolina Dental Board (“Board”) was not insulated from federal antitrust liability under the so-called “state action” doctrine when it engaged...more
On March 9, 2015, the Supreme Court ruled unanimously that when a federal administrative agency wants to amend or repeal an “interpretive rule,” it does not have to follow the notice-and-comment procedures set forth in the...more
Perhaps never before have employers faced so many challenges when it comes to health care issues affecting their workforce. Congress may try to amend the Affordable Care Act (“ACA”). The Supreme Court of the United States is...more
2/26/2015
/ Affordable Care Act ,
Department of Labor (DOL) ,
Employer Group Health Plans ,
Equal Employment Opportunity Commission (EEOC) ,
Flexible Spending Accounts ,
GINA ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Health Savings Accounts ,
Individual Mandate ,
Preexisting Conditions ,
SCOTUS ,
Tax Credits ,
Telehealth ,
Telemedicine ,
Wellness Programs
On July 22, 2014, the U.S. Court of Appeals for the D.C. Circuit and the U.S. Court of Appeals for the Fourth Circuit issued conflicting opinions on a key aspect of the Affordable Care Act ("ACA"). The cases are Halbig v....more
7/30/2014
/ Affordable Care Act ,
Appeals ,
Barack Obama ,
Employer Mandates ,
En Banc Review ,
Halbig v Burwell ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Reform ,
King v Burwell ,
SCOTUS ,
Subsidiaries ,
Tax Credits
Employers attempting to manage corporate compliance programs while balancing privacy concerns and whistleblower protections might find a certain irony, perhaps empathy, in the Obama administration's recent petition for U.S....more
3/7/2014
/ CFTC ,
Confidentiality Agreements ,
Dodd-Frank ,
Lawson v FMR ,
NTSA ,
Retaliation ,
Sarbanes-Oxley ,
SCOTUS ,
Securities and Exchange Commission (SEC) ,
Separation Agreement ,
Training ,
Transportation Security Administration ,
Whistleblower Protection Policies