Health Care Law Blog

Choosing Your Health Care Alliance Partner

Everyone in the health care industry is confronted with consolidation.  If you are a health care provider, you are likely to be confronted with it as governmental regulations and cost pressures continue to prompt alliances and networks among competitors.  Also, anyone looking to engage in the new Accountable Care Organizations created by the Health Reform Act most likely will be joining forces with additional health care entities.  As a health care business attorney, I have been on both sides of the table.  If you are considering an alliance, here are a few suggestions for you to consider based upon my experience in selecting an alliance or network partner. Read More ›

Categories: Health Care Reform, Hospitals, Insurance, Physicians

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4th Circuit Opinions on Health Care Reform Sidestep Issue of Constitutionality

The 4^th Circuit Court of Appeals has issued two opinions related to the Patient Protection and Affordable Care Act ("PPACA"), also commonly referred to as Health Care Reform.  What is interesting in these two decisions is that the appellate court refrains from ruling on the constitutionality of PPACA.  Instead, it does not even address the issue because it found adequate grounds to dismiss both cases based on lack of jurisdiction. Read More ›

Categories: Employment, Health Care Reform, Insurance, Regulatory

Posted by: Mindi M. Johnson

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Score Tied: Health Reform - 1, Opponents - 1

The 11^th Circuit Court of Appeals recently issued a decision declaring that the "individual mandate" provisions of the Patient Protection and Affordable Care Act ("PPACA") are unconstitutional.  This decision directly conflicts with the decision issued by the 6^th Circuit Court of Appeals earlier this summer. Read More ›

Categories: Health Care Reform, Hospitals, Insurance, Physicians

Posted by: Mindi M. Johnson

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US Supreme Court Receives Health Reform Challenge

In the race to the top, the 6^th Circuit decision upholding the constitutionality of the Patient Protection and Affordable Care Act ("PPACA") is the first to come before the United States Supreme Court.  In response to the 6^th Circuit's adverse ruling against it (discussed here), the Thomas More Law Center, et. al., recently petitioned the Supreme Court for review.

The Petition specifically presents two questions for consideration by the Supreme Court: Read More ›

Categories: Health Care Reform, Insurance

Posted by: Mindi M. Johnson

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First Appellate Holding: PPACA is Constitutional

On June 29, 2011, the 6^th Circuit Court of Appeals issued the first appellate decision with regard to the constitutionality of the Patient Protection and Affordable Care Act ("PPACA").  In a split decision (2-1), the court upheld the minimum coverage provision of PPACA (also know as the 'individual mandate') as constitutional.  The individual mandate essentially fines non-exempt persons for not securing minimum essential health insurance coverage. The court noted that this provision was effectively a regulation on the practice of self-insuring (an individual's actions in arranging his or her own financial affairs to compensate for future health care needs). Read More ›

Categories: Health Care Reform, Insurance

Posted by: Mindi M. Johnson

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Michigan Supreme Court Issues Decision on Small Employer Group Health Coverage

Small employers may soon expect to see provisions in their health plan policies requiring them to make minimum contributions to their employees' premiums as a result of a recent Michigan Supreme Court decision. On May 17, 2011, the Supreme Court of Michigan rendered a decision interpreting a provision in the Small Group Health Coverage Act (the "Act"), a law that requires every insurance carrier wishing to provide health care benefits to small employers in Michigan to offer all of its small-employer health plans to all small employers. MCL 500.3701 et. seq.

Categories: Billing/Payment, Employment, Insurance

Posted by: Jennifer Kildea Dewane

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CMS Stopping Acceptance of Early Retiree Reinsurance Applications

The Centers for Medicare and Medicaid Services ("CMS") announced that it will no longer accepting applications for its Early Retiree Reinsurance Program.  Based upon the applications that CMS has accepted and the rate at which the available $5 Billion is being disbursed, the government projects that it will use up the full allotted $5 Billion which has been set aside to fund this temporary program. 

Applications were first accepted on June 29, 2010 and the government is cutting off any further applications May 5, 2011.

Categories: Health Care Reform, Insurance

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