News & Analysis as of

Patient Protection and Affordable Care Act (PPACA) › Insurance Industry › Centers for Medicare & Medicaid Services (CMS)

The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal... more +
The Patient Protection and Affordable Care Act (PPAC), also known as Obamacare, is a United States federal statute passed in March of 2010. The Act creates a nationwide insurance system and provides federal subsidies to reduce the number of uninsured citizens. less -
Hall Benefits Law

HHS Issues Proposed Rule on Nondiscrimination in Health Programs and Activities

Hall Benefits Law on

The U.S. Department of Health and Human Services (HHS) has issued a proposed rule entitled “Nondiscrimination in Health Programs and Activities.” The proposed rule, designed to advance health equity and protect people from...more

Sheppard Mullin Richter & Hampton LLP

The Intersection of Artificial Intelligence and Utilization Review

Sheppard Mullin Richter & Hampton LLP on

California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the California Medical...more

Venable LLP

NAIC Working Group Approves Revisions to Regulate Health Insurance Lead Generators

Venable LLP on

This August, a working group sponsored by the National Association of Insurance Commissioners (the "NAIC") unanimously approved revisions to the NAIC's Unfair Trade Practices Act Model #880 (the "Model Law") to restrain...more

King & Spalding

Court of Appeals Upholds CMS Rule Requiring Public Disclosure of Prices Negotiated Between Hospitals and Insurance Companies

King & Spalding on

On December 29, 2020, the U.S. Court of Appeals for the District of Columbia Circuit upheld a CMS final rule promulgated in November 2019 that requires hospitals to disclose various forms of pricing information related to the...more

Troutman Pepper

CMS Thwarts Idaho's Attempts to Skirt Affordable Care Act, But Provides a Path Forward

Troutman Pepper on

Last month, we reported that Idaho announced a controversial plan to allow insurers to sell policies that do not comply with certain ACA requirements — a move that some feared would set a precedent for other states. ...more

BakerHostetler

Reducing the Regulatory Stranglehold on Federally Facilitated Exchanges: Will It Work?

BakerHostetler on

The Centers for Medicare and Medicaid Services (CMS) recently issued a proposed rule aimed at improving the individual and small group markets that have been plagued with instability as issuers continue exiting the Exchanges....more

Hogan Lovells

Trump administration issues proposed health insurance market stabilization rule: Will it be enough to stabilize exchange...

Hogan Lovells on

On 15 February 2017, the Centers for Medicare & Medicaid Services (CMS) took a step toward addressing concerns about the stability of the individual and small group health insurance markets by proposing a modicum of...more

Alston & Bird

A&B Healthcare Week in Review

Alston & Bird on

I. REGULATIONS, NOTICES, & GUIDANCE - On March 15, 2016, the Centers for Disease Control and Prevention (CDC) issued voluntary guidelines entitled, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United...more

Carlton Fields

Kane v. Healthfirst and the 60-day Repayment Rule

Carlton Fields on

Case: Kane v.Healthfirst, Inc. et al. and U.S. v. Continuum Health Partners Inc. et al., case number1:11-cv-02325, in the U.S. District Court for the Southern District of New York. As part of the Affordable Care Act...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - June 2015 #4

Manatt, Phelps & Phillips, LLP on

This week...no clear consensus has emerged among congressional Republicans on how to manage potential King v. Burwell fallout; California will expand Medicaid to undocumented children; and New York is poised to become the...more

Manatt, Phelps & Phillips, LLP

Manatt on Health Reform: Weekly Highlights - February 2015 #4

Manatt, Phelps & Phillips, LLP on

Wrapping up the 2015 enrollment period, Healthcare.gov and State-based Marketplaces in seven states have announced special enrollment periods (SEPs) for people who were uninsured in 2014 and discover they owe a “shared...more

King & Spalding

CMS Letter to State Insurance Commissioners Offers Transitional Policy to Prevent Health Insurance Issuers from Cancelling Plans...

King & Spalding on

On November 14, 2013, the CMS Center for Consumer Information and Insurance Oversight issued a letter to State Insurance Commissioners announcing a “transitional policy” to permit health insurance issuers to continue plan...more

King & Spalding

CMS Releases Rules on Notice of Benefits and Payment Parameters Implementing Risk Adjustment, Reinsurance and Risk Corridor...

King & Spalding on

On March 1, 2013, CMS released a proposed rule, an interim final rule and a final rule—set for publication in the Federal Register on March 11, 2013—that implement the risk adjustment, reinsurance and risk corridor programs...more

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