Tag Archives: Affordable Care Act

OIG Revamps Regulations Concerning CMPs and Exclusion

In a pair of proposed rules published in May, the HHS OIG unveiled changes to the regulations concerning OIG’s authority to impose civil monetary penalties (CMPs) and exclude individuals and entities from participation in federal healthcare programs. The changes are largely driven by provisions in the Affordable Care Act (ACA) and illustrate OIG’s expansion of … Continue Reading

Is It a Violation to Help?

In a May 21, 2014, letter to the President of the American Hospital Association (AHA), U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius confirmed HHS’s position that private, not-for-profit foundations may, within certain parameters, pay for premiums and cost-sharing expenses for enrollees in qualified health plans (QHPs) sold through the health insurance … Continue Reading

Federally Qualified Health Centers: Welcome to PPS

The Centers for Medicare & Medicaid Services (CMS) recently finalized a new prospective payment system (PPS) for Federally Qualified Health Center (FQHC) services. The implementation of the PPS was mandated by the Affordable Care Act (ACA). Medicare currently pays FQHCs an all-inclusive rate for the professional component of qualified primary and preventive health services furnished to the … Continue Reading

Five Health Policy Issues to Watch in 2014

As we head into the mid-term election cycle, the ongoing implementation of the Patient Protection and Affordable Care Act (ACA) continues to consume the nation’s healthcare industry and political leaders in 2014. On the horizon are several issues likely to dominate congressional time, despite the health policy fatigue felt by most legislators. Below is a … Continue Reading

Employer Shared Responsibility Final Regulations Offer Partial Temporary Enforcement Relief

Editor’s Note:  This post originally appeared in BakerHostetler’s Health Care Reform executive alert. Enforcement of the employer shared responsibility provisions of the Affordable Care Act (ACA) has been further delayed for employers with between 50 and 99 full-time equivalent employees and temporarily eased for employers with 100 or more full-time equivalent employees. The relief was announced on February … Continue Reading
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