The Patient Protection and Affordable Care Act’s Individual Mandate is Upheld...
The United States Supreme Court has upheld the 2010 Patient Protection and Affordable Care Act’s individual mandate not because it is as an exercise of Congressional power under the Commerce Clause,...
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Affordable Care Act: Bundling Payments to Control Costs
Now that the Affordable Care Act has been upheld by the U.S. Supreme Court, the requirement to control costs is critical. One thing we can learn from the experience of near universal coverage in...
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Accountable Care and Collaboration Among Providers
In order for an accountable care organization to succeed, there must be a workable method for collaboration among the providers. How do providers of care effectively communicate amongst one other?...
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Health Systems as Providers and Insurers
Historically, health care services have been paid for by health insurance companies which accept monthly premium payments from employer groups and individuals. The premium for defined health care...
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Are Mandatory Price Controls the Answer to America’s Health Care Woes?
In this election season, both presidential candidates offer plans to deal with the rising cost of providing health care services, the President’s “Obamacare” by increasing the number of insured...
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Obama Care Employer Mandates: Who Must Comply?
The Patient Protection and Affordable Care Act of 2010 (“PPACA” or “Obama Care”) requires, beginning in 2014, that employers with 50 or more full-time employees (“large employers”) offer “affordable”...
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“Affordable” Health Coverage Under Obama Care
As Chris Kutner explained in his January 4, 2013 post, the Patient Protection and Affordable Care Act of 2010 (“PPACA” or “Obama Care”) requires, beginning in 2014, that employers with 50 or more...
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Essential Health Coverage Benefits – The ACA Final Rule
The U.S. Department of Health and Human Services (HHS) has issued a final rule stating the future health insurance exchange (“Exchange”) and insurance issuer standards related to coverage of essential...
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Out-of-Network Billing – New Hope for Patients
Unexpected bills to patients for out-of-network medical care have been a problem for years. Patients, their providers – both in and out-of-network – and the insurance carriers (the “payors”) have...
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Are Suits Opposing Obamacare Mandates Ripe?
Over fifty cases across the country have challenged regulations promulgated under the Patient Protection and Affordable Care Act (“PPACA” or “Obamacare”) that require employer group health insurance...
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Hannon, Helgerson to speak on Medicaid Redesign
Senator Kemp Hannon, Chair of the New York State Senate Committee on Health (and counsel at Farrell Fritz), will be hosting a health care forum featuring a presentation by State Medicaid Director...
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Wellness Programs Under the Affordable Care Act
On May 29, 2013, the US Departments of Health and Human Services, Labor, and Treasury issued final regulations regarding wellness programs under the Patient Protection and Affordable Care Act (the...
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Photocopiers and HIPAA – Health Plan Settles with HHS for $1.2 Million
Is your office photocopy machine a HIPAA time-bomb? Affinity Health Plan recently learned that the answer is yes, to the tune of a $1.2 million settlement with the US Department of Health and Human...
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Affordable Care Act Employer Notice Deadline Nears
(This post was authored by Heather Harrison, an associate in the Labor & Employment practice at Farrell Fritz) Although key provisions of the Patient Protection and Affordable Care Act (ACA) have...
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EDNY Judge Enjoins Enforcement of HHS Mandate
Earlier this week, in Roman Catholic Archdiocese of New York v. Sebelius, U.S. District Judge Brian Cogan in the Eastern District of New York permanently enjoined the government from enforcing...
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Private Right of Action Recognized Under New York’s Prompt Pay Law
Claimants have a private right of action against insurers under New York’s Prompt Pay Law, N.Y. Ins. Law 3224-a, according to the Appellate Division in Maimonides Med. Ctr. v. First United Am. Life...
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Court of Appeals Upholds Comptroller Audit Of Non-Participating Provider’s...
The New York Court of Appeals decided last week, in Handler v. DiNapoli, that the State Comptroller has the authority to review the billing records of a non-participating provider receiving funds from...
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Visiting Nurse Service Settles Some SDNY False Claims Act Allegations, Leaves...
An interesting SDNY settlement agreement resolves some False Claims Act allegations, but leaves others for another day. Visiting Nurse Service of New York (VNS) paid just under $35 million to the...
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Congressional Appropriations Riders Suspended Affordable Care Act Mandates On...
In a decision last week that could affect $12 billion that insurers assert is owed by the federal government, the Federal Circuit decided that HHS was not required to pay amounts required by statute...
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Healthcare Bills Passed in the 2018 Legislative Session
The scheduled 2018 New York State Legislative Session concluded last week amid many of the same speculations and controversies that have characterized all of the Legislature’s activities in recent...
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