Health Care Law Blog

Proposed Rules Related to Coverage of Contraceptive Services Just Released

On January 30, 2013, the Departments of Treasury, Labor, and Health and Human Services (collectively, the “Departments”) jointly released proposed rules related to the coverage of preventive services under the Patient Protection and Affordable Care Act (“PPACA”).  When initially enacted, PPACA required certain health plans to provide benefits for particular preventive health services, including coverage of contraceptives, without the imposition of cost sharing measures (i.e., individuals covered by the plan would not be required to pay anything for the services).  This coverage requirement became effective on the first day of the plan year that followed August 1, 2012.  For calendar year plans, the effective date was January 1, 2013. Read More ›

Categories: Employee Benefits, Health Care Reform, Insurance, Regulatory

Posted by: Mindi M. Johnson

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Delayed Deadline: Employer Notice Regarding Health Insurance Exchanges

As previously discussed, the Patient Protection and Affordable Care Act requires employers to provide notice to their employees related to Health Insurance Exchanges (the “Notice”). The specifics concerning the Notice may be found here. The Notice was required to be given to each current employee not later than March 1, 2013. Read more about the delay ›

Categories: Health Care Reform, Health Insurance Exchange, Hospitals, Insurance, Physicians, Regulatory

Posted by: Mindi M. Johnson, Johanna M. Novak

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Employer Mandate and the Controlled Group Rules

Employers with 50 or more full time equivalent employees (“FTEs”) will be subject to a penalty tax for: (1) failing to offer health care coverage to all full time employees; ( 2) offering minimum essential coverage that is unaffordable; or (3) offering minimum essential coverage where the Plan pays less than 60% of cost.   This is often referred to as the Employer Mandate of PPACA. Read More ›

Categories: Employee Benefits, Health Care Reform, Insurance, Regulatory

Posted by: Mindi M. Johnson

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Blue Cross Changes on the Horizon?

Changes to the health insurance market in Michigan may soon be changing due to the Michigan House of Representatives’ approval of Senate Bills 1293 and 1294 (the “Senate Bills”) on December 6, 2012.  The introduction of the Senate Bills follow Governor Snyder’s proposed overhaul of BCBSM discussed here and directly address the corporate organization and continued operation of Blue Cross Blue Shield of Michigan (“BCBSM”) in our state.  In brief, the Senate Bills authorize BCBSM to establish, own, operate and merge with a nonprofit mutual disability insurer.  They also generally prohibit BCBSM from using “Most Favored Nation Clauses” in provider contracts beginning February 1, 2013.  While the Senate Bills are not final until Governor Snyder signs them into law, given his previous support it is likely he will give his approval. A more detailed analysis of the Senate Bills will be provided if the Governor does indeed sign them into law.

Categories: Billing/Payment, Insurance, Regulatory

Posted by: Mindi M. Johnson

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Insurance Exchange Deadlines Further Extended

As we previously reported, the Department of Health & Human Services (“DHHS”) extended some important deadlines for states establishing State-Based Insurance Exchanges or State Partnership Exchanges for 2014.  Specifically, DHHS extended the submission deadline for State-Based Exchange Blueprints to December 14, 2012.  However, the administration previously still required states to submit Declaration Letters of their intent to build state-based Health Insurance Exchanges by November 16^th.  However, as of Thursday (November 15^th), only 17 states and the District of Columbia had committed to building their own Exchanges.  This is far fewer than envisioned by the Obama administration when the law was passed in 2010. To give states more time, the Obama administration extended the deadline for the Declaration letters until December 14^th.  Thus, both Blue Prints of the specifics of the Exchange and Declaration Letters of states wishing to run their own Exchange are due on December 14^th. Read More ›

Categories: Health Care Reform, Health Insurance Exchange, Insurance

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Patient Protection and Affordable Care Act Marches On

As President Obama moves into his second term, health care reform moves forward with him. Wholesale repeal of the Patient Protection and Affordable Care Act (PPACA) now seems highly unlikely. With the majority of the PPACA provisions slated to go into effect in 2014, employers need to be ready.

Foster Swift has developed guides to aid employers with their preparation efforts. Click the links below to download these guides.

Documents updated 07-12-2013

If you have any questions regarding health care reform, please contact a member of the Foster Swift Health Care Law Group.

Categories: Employee Benefits, Employment, Health Care Reform, Hospitals, Insurance, Physicians, Regulatory

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Michigan will Pursue Federal Partnership for its Health Insurance Exchange

At the end of August, Governor Rick Snyder announced that Michigan will be pursuing a federal-state partnership for its health insurance exchange.  Health insurance exchanges are a requirement of the federal Health Care Reform law.  Health insurance exchanges are designed to  facilitate the purchase of health insurance by consumers through an online, cost-competitive forum.  Each state has the option to: (1) operate its own health insurance exchange; (2) partner with the federal government; or (3) allow the federal government to manage its health insurance exchange. Read More ›

Categories: Employee Benefits, Health Care Reform, Health Insurance Exchange, Insurance, Regulatory

Posted by: Mindi M. Johnson

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Foster Swift Lawyers Attend Annual State Bar of Michigan Health Care Law Section Meeting

Foster Swift lawyers were well represented at the Annual Meeting of the State Bar of Michigan's Health Care Law Section held on September 19th. Gilbert Frimet, Gary McRay, Jennifer Kildea Dewane, and Nicole Stratton, members of Foster Swift Health Care Law Practice Group, all traveled to Detroit to attend the meeting.  Read More ›

Categories: Health Care Reform, Health Insurance Exchange, Hospitals, Insurance, Medicare/Medicaid, Physicians, Regulatory

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Employers Must Provide Notice of Health Insurance Exchanges

With the United States Supreme Court having ruled that nearly all of the provisions in the Patient Protection and Affordable Care Act (“PPACA”) are constitutional, employers are legally obligated to comply with PPACA's requirements. One such requirement of particular interest to employers is the employee health insurance exchange notice requirement. Read More ›

Categories: Employee Benefits, Employment, Health Care Reform, Health Insurance Exchange, Insurance

Posted by: John W. Mashni

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Governor Snyder Proposes Total Overhaul to Blue Cross Blue Shield of Michigan

Governor Rick Snyder in a press conference this morning proposed a total overhaul of Blue Cross Blue Shield of Michigan ("BCBSM").  Governor Snyder's proposal would:

1. covert BCBSM to a non-profit mutual company;
2. end its tax exemption; and
3. remove Attorney General review of requested rates. 

In essence, Michigan would treat BCBSM as it would any other health insurer as BCBSM would be regulated by the Insurance Code.  While this proposal may seem drastic, it is not surprising given recent regulation orders by the Office of Financial and Insurance Regulation ("OFIR") curtailing BCBSM's use of most favored nation clauses ("MFN Clauses") and rejecting the low rates that it charges to hospitals and other providers. Read More ›

Categories: Hospitals, Insurance, Physicians, Regulatory

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