A study by researchers at Harvard Medical School says an Act intended to make hospitals more efficient is unintentionally punishing hospitals that serve the sickest, poorest and least-educated patients. Under …
2016 Presidential Election
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EditorialsLegislationRegulations
Penalties Double For ACA Filing Failures
by Robert Sheenby Robert SheenPenalties for failure to satisfy the complex IRS filing requirements resulting from the Affordable Care Act (ACA) have just doubled. With filing deadlines approaching, employers should act quickly to ensure …
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The Internal Revenue Service has issued proposed regulations that will require employer-sponsored health care plans to include “substantial coverage” for in-patient hospitalization and physician services. So-called “skinny” plans that lack …
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Affordable Care ActHealth Care Coverage
Key Dates for ACA Open Enrollment
by Robert Sheenby Robert SheenNovember 1, 2015 – Open Enrollment begins. Individuals can apply for, drop, keep or change their Insurance plans. December 15, 2015 – Individuals must enroll by this date if they …
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A decision by the National Labor Relations Board that franchisors and companies using staffing agencies can be considered joint employers is expected to have a significant impact on companies that …
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Affordable Care ActReportingTax Filings
$11 Billion in Credits Paid During Filing Season
by Robert Sheenby Robert SheenConsumers who bought individual health insurance coverage through federal and state exchanges received almost $11 billion in premium assistance tax credits in fiscal year 2014, according to a report by …
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LegislationRegulationsUncategorized
ACA Reporting Requirements For Large Employers
by Robert Sheenby Robert SheenCompanies with 50 or more full-time employees should be gathering information now for Affordable Care Act reports they will have to provide to the IRS and to their employees early …
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Affordable Care ActPremium Tax Credit
Tools to Estimate ACA Fees and Credits
by Robert Sheenby Robert SheenThe IRS has developed tools for employers and individuals to estimate their credits and payments related to the Affordable Care Act. The tools, available online, only provide an estimate intended …
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LegislationRegulations
Misclassifying Workers Can Trigger Two Penalties
by Robert Sheenby Robert SheenEmployers are facing increased scrutiny by the Department of Labor, the and state regulators over possible misclassification employees as independent contractors or freelance workers. A DOL memo states that the …
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RegulationsUncategorized
Balance Billing Undermines Insurance Coverage
by Robert Sheenby Robert SheenA key goal the Affordable Care Act is to make sure that the medical is covered by insurance plus the agreed-upon deductibles and copays. But for many families an illness …
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Four studies published in mid-August indicate that the Affordable Care Act is achieving its goal of reducing the number of Americans without health insurance while having no negative impact on …
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EditorialsLegislationRegulations
Why You Can’t Afford to Ignore The ACA
by Robert Sheenby Robert SheenLike all owners of small businesses, the men and women who run construction Companies had more than enough to do before the Affordable Care Act added one more task — …
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Affordable Care ActRegulations
Are You Subject to the Individual Mandate?
by Robert Sheenby Robert SheenThe IRS has issued an explanation of which U.S. citizens and foreign nationals are subject to the individual shared responsibility provision of the Affordable Care Act, or the “individual mandate.” …
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Affordable Care ActHealth Care Coverage
Uninsured Rate is 9.2%, a Record Low
by Robert Sheenby Robert SheenOnly 9.2% of Americans are without health insurance, the Centers for Disease Control and Prevention reported. This is the lowest rate since the CDC began keeping records in 1972. The …
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Cadillac TaxRegulations
IRS Asks For Comments on New “Cadillac Tax” Rules
by Robert Sheenby Robert SheenThe Internal Revenue Service has identified additional issues under Code Section 4980I, commonly known as the “Cadillac Plan” excise tax, and is proposing new regulations to deal with them. The …
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A Wyoming Indian tribe lost a legal bid to be exempted from the employer mandate of the Affordable Care Act, and must provide health insurance to all of its employees. …
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EditorialsLegislation
ACA Reporting Update: New Forms, Higher Penalties
by Robert Sheenby Robert SheenACA Reporting Update: New Forms, Higher Penalties By Damian A. Myers Damian Myers is an Associate in the Employee Benefits, Executive Compensation and ERISA Litigation Practice Center in the Washington, …
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Affordable Care ActLegislationMedicaid/Medicare
Medicare and Medicaid Popular After 50 Years
by Robert Sheenby Robert SheenWhen Medicare and Medicaid were signed into law on July 30th 50 years ago, opponents attacked the programs as wasteful, intrusive and a precursor to socialism or communism. Today both …
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The IRS issued a reminder that individuals who received advance payments of the Premium Tax Credit (PTC) in 2014, for insurance they purchased through a marketplace or exchange, should file …
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LegislationRegulationsUncategorized
IRS on Employer Shared Responsibility Provisions
by Robert Sheenby Robert SheenThe Internal Revenue Service has issued a reminder to employers about specific “shared responsibility” provisions of the Affordable Care Act that may affect them. The size and structure of a …
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New reporting requirements mandated by the Affordable Care Act are posing challenges to large and small companies, and most employers have made little progress on deciding on or implementing a …
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LegislationRegulations
California Health Insurance Rates To Rise By 4%
by Robert Sheenby Robert SheenCalifornia’s Affordable Care Act exchange, known as Covered California, has negotiated an average 4% increase in premiums for the 1.3 million residents of the state who buy individual insurance through …
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An increasing amount of medical care is being delivered by nurse practitioners, physician assistants and other non-physician providers, making care more widely available and helping hold down costs, according to …
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The Internal Revenue Service (IRS) issued a reminder that all employers that provide self-insured health coverage, must file an annual return reporting certain information for each employee they cover. If …
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After two years of debate and months of closed-door negotiations, Utah’s Republican governor and state legislature have agreed on a deal to expand Medicaid in that state, covering about 126,000 …
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Affordable Care ActLegislationRegulations
ACA Offers Help For Informal Caregivers
by Robert Sheenby Robert SheenMillions of Americans who provide unpaid care for ill, disabled or aged family members or friends can now get help through the Affordable Care Act for their own physical and …
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Affordable Care ActIRS
IRS Offers ACA Webinars for Employers and Insurers
by Robert Sheenby Robert SheenThe Internal Revenue Service is offering a series of three webinars designed to help employers and insurance providers understand provisions of the Affordable Care Act. The webinars will be held …
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Affordable Care ActHealth Care CoverageMedicaid
Alaska’s Governor Acts to Expand Medicaid
by Robert Sheenby Robert SheenAlaska’s Gov. Bill Walker moved to expand Medicaid, saying he will ask the administration to offer Medicaid coverage to all qualifying residents of the state. Noting that Alaska’s legislature had …
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Despite a few glitches, the Internal Revenue Service says, the agency’s staff did a “commendable” job implementing provisions of the Affordable Care Act. The most significant new challenge the IRS …
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LegislationRegulations
New Rules on Religious Objections to Birth Control
by Robert Sheenby Robert SheenThe Obama administration has unveiled new rules aiming to address religious objections by to providing birth control to female employees as required by the Act.
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EditorialsLegislationRegulations
Impact of ‘King’ on Applicable Large Employers
by Robert Sheenby Robert SheenImpact of ‘King’ on Applicable Large Employers The Supreme Court’s decision in ‘King v. Burwell’ had ramifications for “applicable large employers” that went beyond approving payment of insurance subsidies in …
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Time’s Up on Premium Reimbursement The IRS has taken a hard position on employer payment plans under the ACA, and now the time is up for small employers to comply. …
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Affordable Care ActHealth Care Coverage
Enrollments Alone Don’t Lead to Better Health
by Robert Sheenby Robert SheenDespite the Affordable Care Act’s success in getting 16 million more Americans enrolled in health insurance programs, major hurdles still keep consumers from understanding their coverage, finding a doctor and …
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RegulationsUncategorized
College’s Objection to Contraception Coverage Is Denied
by Robert Sheenby Robert SheenThe US Court of Appeals has denied a religious college’s request to bar the government from enforcing the Affordable Care Act’s requirement that insurance plans cover the cost of all …
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The Affordable Care Act’s requirement that insurers offer coverage to everyone, including those with serious pre-existing medical expenses, has not resulted in a surge of hight-cost claims. The federal agency …
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Information is now available online for 11.4 million financial transactions paid by drug and medical device suppliers to 600,000 physicians and 1,100 teaching hospitals. The payments total $6.49 billion. The …
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LegislationRegulations
After ‘King’ Ruling, States Look at Medicaid Expansion
by Robert Sheenby Robert SheenNow that the Supreme Court has ruled in favor of the administration’s position in the ‘King v. Burwell’ case, supporting the legality of Affordable Care Act subsidies in all states, …
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The changes to America’s health care delivery system introduced by the Affordable Care Act are causing some of the nation’s largest health insurance companies to explore merger talks with competitors. …
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Affordable Care ActLegislation
Supreme Court Rules ACA Subsidies Are Legal
by Robert Sheenby Robert SheenIn a 6-3 decision, the Supreme Court ruled on June 25th that it is legal for government subsidies under the Affordable Care Act to be available to all Americans, as …
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A repeal of the Affordable Care Act would increase the federal deficit by $353 billion over the next 10 years, according to a report by the Congressional Budget Office and …
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The federal agencies that regulate the Act issued a set Frequently Asked Questions (FAQ) to clarify the limits on cost-sharing under the ACA. For plan years beginning in 2016, the …
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The Internal Revenue Service issued revised regulations regarding the Summary of Benefits and Coverage (SBC) that must be provided to those covered by health insurance plans. The SBC is intended …
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American Health Care Act (AHCA)Regulations
Americans Say Prescription Drug Costs Unreasonable
by Robert Sheenby Robert SheenNearly three-quarters of the public (73%) think prescription drugs costs are unreasonable, and place the blame on pharmaceutical companies rather than health insurance companies, aKaiser Foundation poll found. Asked for …
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By a margin of 55% to 38%, Americans believe the Supreme Court should not block federal subsidies in the states that do not operate their own health insurance exchange, an …
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A Republican Congressman has introduced to help individuals who would lose their insurance subsidies if the Supreme Court rules in favour of the plaintiffs in the “King v. Burwell” case. …
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The decision by 22 states not to expand Medicaid under the will ACA will result in 5,200 avoidable deaths each year, according to a White House Report, along with hundreds …
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Unpaid bills, better known as “bad debt,” declined at non-profit hospitals in states that expanded during 2014, according to a study by Moody’s Investors . Hospitals in the 29 states …
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The House Ways and Means Committee approved H.R. 160, which would repeal the 2.3% excise tax on medical device manufacturers imposed under the Affordable Care Act and intended to help …
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The CVS Health pharmacy chain will carry information about healthcare and preventative services, by the U.S. Department and Human Services (HHS), the company’s MinuteClinic.com and CVS.com websites. CVS is using …
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Companies seem to have enjoyed excellent financial during the Act’s first year implementation, despite being forbidden by the law to turn down individuals with pre-existing medical conditions or charge them …