Showing 47 posts in Insurance.
Health Insurance Providers Beware – April 15 is Quickly Approaching
The Patient Protection and Affordable Care Act requires that certain health insurance providers pay an annual fee based on the net premiums they wrote during the preceding calendar year. The providers required to pay this fee include health insurance issuers; health maintenance organizations; certain insurance companies; insurers providing Medicare Advantage, Medicare Part D, or Medicaid coverage; and multiple employer welfare arrangements.
In order to calculate the fees, the Internal Revenue Service (“IRS”) must obtain information related to the amount of net premiums written by each health insurance provider. This is accomplished through IRS Form 8963 (Report of Health Insurance Provider Information). Health insurance providers are required to submit Form 8963 to the IRS by April 15 of each year. Read More ›
Categories: Compliance, Health Care Reform, Insurance, Tax
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Is it the end of the Michigan Marriage Amendment?
Is it the end of the Michigan Marriage Amendment?
In the court case Deboer v Snyder, a federal court judge ruled that the voter-approved Michigan Marriage Amendment prohibiting same-sex couples from marrying in Michigan was unconstitutional. However, the Sixth Circuit Court of Appeals stayed the federal trial court ruling in Deboer v Snyder as the State of Michigan prepares to appeal the decision.
So what does this mean for health care insurers? This means that the Michigan Marriage Amendment banning same-sex marriage remains the law in Michigan until the Sixth Circuit decides the State of Michigan's appeal of the Deboer ruling. However, insurers will want to keep an eye on this case to determine if they should offer same-sex health insurance benefits or change their definitions of spouse under their plans.
For information on what this ruling would mean for employers, see this article by Foster Swift.
Categories: Employee Benefits, Employment, Insurance
Employer Mandate Delayed…Again
On Feb. 12, 2014, the U.S. Department of Treasury and the Internal Revenue Service published final rules (the “Final Rules”) related to the Employer Shared Responsibility provisions of the Patient Protection and Affordable Care Act (“PPACA”). The Employer Shared Responsibility provisions, referred to as the “Employer Mandate,” generally require certain employers to offer minimum essential health care coverage to their full-time employees or face penalties. The Employer Mandate was originally scheduled to become effective on Jan. 1, 2014 but was delayed until Jan. 1, 2015.
The Final Rules include a second delay of the Employer Mandate. They provide that employers who employ 50 – 99 full time equivalent employees will not be required to comply with the Employer Mandate until Jan. 1, 2016. Additionally, those employers who employ 100 or more full time equivalent employees must offer minimum essential coverage to only 70 percent of those full time employees by Jan. 1, 2015 (as opposed to the 95 percent coverage requirement under the previous regulations). Those employers employing 100 or more full time employees will be required to offer coverage to 95 percent of all full time employees by Jan. 1, 2016. The chart below summarizes the basic details concerning this delay. Read More ›
Categories: Health Care Reform, Insurance, Tax
Health Plans Take Notice: Compliance with HIPAA Administrative Simplification Rules is still Required
On Jan. 2, 2014, the Department of Health and Human Services (“HHS”) issued a proposed rule related to the Administrative Simplification requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). Specifically, it delayed the date by which health plans must certify compliance with certain operating rules imposed by the Affordable Care Act (“ACA”).
The ACA required the Secretary of HHS to adopt operating rules related to claims status, eligibility, electronic funds transfers ("EFT") and health care payment and remittance advice transactions ("ERA"). Health plans (and other covered entities) were required to comply with the claims status and eligibility operating rules by Jan. 1, 2013 and the EFT and ERA operating rules by Jan. 1, 2014. Additionally, health plans were required to file a statement with HHS certifying that the health plan is in compliance with the operating rules. This certification statement was due by Dec. 31, 2013. Read More ›
Categories: Billing/Payment, Compliance, Health Care Reform, HIPAA, Insurance, Privacy, Providers
Large Employers Rejoice! PPACA’s Employer Mandate Delayed until 2015
On July 2, 2013, the Obama administration declared that it was delaying the effective date of the Patient Protection and Affordable Care Act’s Employer Mandate until January 1, 2015. The Employer Mandate, which was scheduled to become effective on January 1, 2014, required all large employers to offer health care coverage to their full-time employees or pay a penalty. Most importantly, this delay means that the penalties to large employers for failure to provide health insurance coverage will not be enforced for another year. You may read the full statement issued by the U.S. Department of Treasury here. Read more about his announcement ›
Categories: Employment, Health Care Reform, Insurance
Medicaid Expansion Debate in Michigan Rages On
A key component of the Patient Protection and Affordable Care Act ("PPACA") involves expanding Medicaid to anyone who earns up to 133 percent of the poverty level. In its landmark ruling last year the Supreme Court, while upholding PPACA, ruled that states could not be compelled to expand the joint federal-state Medicaid program.
State legislatures and governors across the country have considered whether to expand Medicaid, with only 23 states and the District of Columbia implementing an expansion according to the (We have identified that the following link is no longer active, and it has been removed.) Under the PPACA, 100 percent of the cost of the Medicaid expansion will be covered by the federal government from 2014 through 2016. The federal government's contribution will gradually decline until reaching 90 percent in 2022 and beyond. What's happening in Michigan? ›
Categories: Health Care Reform, Insurance, Medicare/Medicaid, Regulatory
IRS Issues New Regulations Affecting the “Blues” Under Health Reform
The Treasury Department and IRS continue to roll out new regulations related to the implementation of the Patient Protection and Affordable Care Act ("PPACA"). On May 10, 2013, the Treasury Department and IRS released the draft regulations, "Computation of, and Rules Relating to, Medical Loss Ratio", which are intended to help Blue Cross and Blue Shield ("BCBS") organizations comply with the Medical Loss Ratio (“MLR”) rules created by the PPACA. Here's the background ›
Categories: Health Care Reform, Hospitals, Insurance, Physicians, Regulatory
Antitrust Lawsuit Against Blue Cross Blue Shield of Michigan ("BCBSM") Dropped by the Justice Department
On Monday, March 25, 2013 the Department of Justice along with Blue Cross Blue Shield of Michigan ("BCBSM") jointly filed a motion to dismiss the case against BCBSM regarding their "most-favored nation" contracts. This lawsuit had been going on for 2.5 years and was scheduled for trial in October. Part of the reasoning for this lawsuit being dismissed is that the Insurance Commissioner on February 1, 2013 banned hospitals or insurers from enforcing most-favored nation agreements in insurance contracts unless they are approved by the Insurance Commissioner. Also, as of January 1, 2014 most-favored nation agreements are banned completely.
Categories: Insurance
Blue Cross Blue Shield of Michigan Conversion Bills Signed into Law
While many thought the Blue Cross Blue Shield of Michigan ("BCBSM") conversion bills would be signed into law at the end of 2012, it was not until March 18, 2013 that Governor Snyder signed the proposed legislation into law. The BCBSM conversion bills convert BCBSM from "a tax exempt charitable and benevolent institution" into a nonprofit mutual health insurance company. BCBSM has been operating as a tax-exempt nonprofit since Public Act 350 was signed into law in 1980. (This Public Act is referred to as the previous BCBSM statute.) The previous BCBSM statute made BCBSM Michigan’s “insurer of last resort,” requiring it to accept all customers regardless of their health. Read more about the new laws ›
Categories: Health Care Reform, Insurance, Regulatory
Recap From the 2013 Health Law Institute
On March 7 and 8, 2013, the members of Foster Swift’s Health Care Law Group attended the 19th Annual Health Law Institute. This two-day institute, which is co-sponsored by the Institute for Continuing Legal Education and the Health Care Law Section of the State Bar of Michigan, focused on recent legal developments in health care law. Specific topics addressed at this year’s Health Law Institute included: Read More ›
Categories: Health Care Reform, Health Insurance Exchange, HIPAA, Hospitals, Insurance, Physicians, Regulatory
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Best Lawyers® 2021
Congratulations to the attorneys of the Health Care practice group at Foster Swift Collins & Smith, PC for their inclusion in the Best Lawyers in America 2021 edition. Firm-wide, 44 lawyers were listed. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation and as lawyers are not required or allowed to pay a fee to be listed; inclusion in Best Lawyers is considered a singular honor. Health Care practice group members listed in Best Lawyers are as follows:
- Jennifer B. Van Regenmorter, Holland
To see the full list of Foster Swift attorneys listed in Best Lawyers 2021, click here.