White House: Don't Scrap ACA If Mandate Thrown Out

No Author — Wed, 08 Feb 2012 12:27:00 EST

If the Supreme Court rules that the Affordable Care Act's individual mandate is unconstitutional, the entire law doesn't need to be thrown out, lawyers for the Obama administration argued in a brief filed with the high court.

PQRS: What You Need to Know About Participating in 2012

No Author — Fri, 03 Feb 2012 11:00:00 EST

The Centers for Medicare and Medicaid Services (CMS) recently ruled that providers not successfully/satisfactorily participating in PQRS by the 2013 reporting period (Jan. 1 - Dec. 31, 2013), will have their Medicare reimbursement decreased by 1.5 percent beginning in 2015, and 2 percent in 2016.

Therefore, the 2012 reporting period is the last opportunity providers have to voluntarily participate in PQRS and learn how to report successfully/satisfactorily while incentives are still offered and their Medicare reimbursement is not subject to penalties.

Feds Don't Exempt Texas From Health Reform 80% Rule

No Author — Mon, 30 Jan 2012 06:36:00 EST

The federal government on Friday refused to let Texas ease a requirement that health insurers devote at least 80 percent of premium revenue to medical care.

Officials of the U.S. Department of Health and Human Services said Texas insurance regulators did not convincingly back up their claim that immediate enforcement of the medical-spending minimums would disrupt the state's 'individual market.'

ACA to Bring Influx of Diabetics to Medicaid

No Author — Tue, 17 Jan 2012 06:33:00 EST

Health reform will increase the number of uninsured adults with diabetes who will be covered by Medicaid, researchers found. That will expand access and increase the use of healthcare in a population that has many unmet healthcare needs.

In 2010, Medicaid covered about 60 million Americans, and in 2014 that figure will expand by about 16 million as more uninsured patients become eligible for the program as a result of the Affordable Care Act; about a million of these patients will have diabetes.

States File Brief Opposing ACA's Medicaid Expansion

No Author — Mon, 16 Jan 2012 11:24:00 EST

States for and against Health Care Reforms file briefs with Supreme Court.

Brief Filed With Supreme Court

No Author — Wed, 11 Jan 2012 12:28:00 EST

The Obama administration has filed its initial brief in the Supreme Court case that will determine the constitutionality of the Affordable Care Act.

Appeals Court Upholds Healthcare Reform Law

No Author — Mon, 28 Nov 2011 12:03:00 EST

The D.C. Circuit Court of Appeals has ruled in favor in a 2-1 decision that the individual mandate provision of the Affordable Care Act (ACA) is constitutional.

The individual mandate 'certainly is an encroachment on individual liberty,' said the majority, 'but it is no more so than a command that restaurants or hotels are obliged to serve all customers regardless of race ... or that a farmer cannot grow enough wheat to support his own family.'

Supreme Court Announces It Will Decide Health Care Reform

No Author — Mon, 14 Nov 2011 14:30:00 EST

The Supreme Court has announced it will consider the Affordable Care Act (ACA) during its current session. Oral arguments are expected to be heard this spring.

Read More in this article.

Federal Regulation Expands Role of DCs in Health Care Reform

No Author — Tue, 08 Nov 2011 10:32:00 EST

On October 20th, the Centers for Medicare and Medicaid Services (CMS) released their final rule regarding the CMS Shared Savings/Accountable Care Organization Program .... In CMS' final rule, CMS indicated that nothing would 'preclude Medicare enrolled chiropractors from participating in ACOs, or from sharing in the savings that an ACO may realize in part because of the quality and cost-effective services they may be able to provide.''

CMS Releases Final ACO Rule

No Author — Thu, 27 Oct 2011 10:37:00 EST

The federal government released its long-awaited final rule on Accountable Care Organizations (ACOs), and the U.S. scored pretty dismally on a report card that looked at healthcare quality, access, and efficiency.

The U.S. scored a 64 out of 100 overall for key measures of healthcare performance that pitted the nation as a whole against high-performing regions in the U.S., as well as against other countries.

The report also found that the nation spends up to twice as much as other high-income countries, but doesn't have better care to show for it.

Health Reform Law Could Reach Supreme Court Sooner

No Author — Wed, 28 Sep 2011 15:28:00 EST

The healthcare reform law is more likely than ever to end up in the Supreme Court -- and fairly soon -- because the Obama administration deliberately missed an important deadline on Monday for a lower court to rehear a case against the law.

On Wednesday, September 28, 2011, the Obama administration filed a petition with the Supreme Court asking for a speedy ruling on the constitutionality of the Affordable Care Act.

More Young Adults Covered by Health Insurance

No Author — Mon, 26 Sep 2011 13:00:00 EST

About a million more people ages 19 to 25 had health insurance in the first quarter of 2011 than in the same time period in 2010, according to figures released Wednesday by the Department of Health and Human Services. That brought the percentage young adults with health coverage to 69.6%, up from 66.1%, according to data from the National Center for Health Statistics.

HHS officials pegged the increase to a provision of the Affordable Care Act (ACA).

Plan Cuts Billions from Medicare, Medicaid

No Author — Thu, 22 Sep 2011 13:51:00 EST

In a speech from the Rose Garden on his 'American Jobs Act,' the president outlined his deficit-reduction plan.

'And we'll change the way we pay for healthcare,' President Obama said. 'Instead of just paying for procedures, providers will be paid more when they improve results -- and such steps will save money and improve care.'

Of the $248 billion in proposed cuts to Medicare, 90% would come from 'reducing overpayments in Medicare,' which would mean providers, including doctors and hospitals, would likely be paid less for treating Medicare patients. The campaign against overpayments also would likely extend to drug companies and insurers.

The president's plan is meant to be a starting point for the bipartisan 'super committee' tasked with identifying $1.5 trillion in cuts in federal spending by Thanksgiving.

If Congress fails to vote on the agreement by Dec. 23, or if the super committee can't come to an agreement, a 'trigger option' will kick in, making automatic cuts of $1.2 trillion. The healthcare portion of those automatic cuts will spare Medicare beneficiaries and only be aimed at doctors and hospitals.

States Begin Review of Insurance Premium Hikes

No Author — Tue, 13 Sep 2011 12:03:00 EST

Health insurers who want to raise premiums by 10% or more will now be subject to state or federal review as well as public scrutiny. Sept. 1 is the effective date for a provision in the Affordable Care Act (ACA) that gives states the authority to issue a review of any insurer that raises premiums for small or individual health insurance plans by more than 10% in a given year.

In addition, the insurance company will have to publicly report its premium increase plan on a Web site and justify why such a hike is needed.

Two Health Reform Lawsuits Rejected by Appeals Court

No Author — Fri, 09 Sep 2011 12:22:00 EST

The 4th U.S. Circuit Court of Appeals has thrown out two challenges to the healthcare reform law on the grounds that neither of the plaintiffs had the right to sue the federal government.

The court did not rule on whether the mandate is constitutional or not.

In one case the judges said that, because the suit involves 'pre-enforcement action seeking to restrain the assessment of a tax,' litigation is premature under a federal law that prohibits citizens from suing the government over a tax until after they have actually paid it.'

'In referring to the penalty for not having insurance as a 'tax,' the court may have bolstered the administrations's agrument that the fee is a 'tax' and thus in the government's purview.'

it is now incumbent on the Supreme Court to decide whether the individual mandate is legal, but whether it would do so before the November 2012 election was unclear.

Insurer Profits Expected to Shrink After ACA

No Author — Fri, 02 Sep 2011 06:31:00 EST

The Affordable Care Act is turning out to be a 'mixed blessing' for the insurance industry, which will see its business double, but its profit margins dwindle, according to a new report.

According to a new projection from the Boston Consulting Group, insurance industry revenues are expected to double to more than $1.2 trillion from 2011 to 2019 as an influx of previously uninsured people buy coverage.'

'However, the industry's profit margin could decline from nearly 5% to below 3% during that time period. Under that projection, the insurance industry's profits would grow from $27 billion in 2011 to $34 billion in 2019.

11th Circuit Court Rules Individual Insurance Mandate Unconstitutional

No Author — Sat, 13 Aug 2011 10:33:00 EST

The 11th Circuit Court of Appeals has ruled that the individual mandate portion of the Affordable Care Act (ACA) is unconstitutional, but that the rest of the law can stand.

The 2-1 decision starkly contrasts with a June decision from the 6th Circuit Court of Appeals that ruled the individual mandate is constitutional.

The federal government will now have 90 days to appeal to the Supreme Court or to ask the full appeals court to review the case.

First ACA Case Goes to Supreme Court

No Author — Thu, 28 Jul 2011 06:48:00 EST

The Thomas More Law Center has filed a petition this week in the U.S. Supreme Court asking it to rule on the law center's case against the Affordable Care Act (ACA). It is the first of its kind to reach the nation's highest court.

If the Supreme Court agrees to take it, 'the case will in all likelihood be briefed, argued, and decided in this upcoming term, with a decision rendered prior to the Court recessing next summer.'

CMS proposes rule for Medicaid's "equal access" requirement

No Author — Thu, 21 Jul 2011 06:33:00 EST

The Affordable Care Act (ACA) relies on Medicaid to expand coverage for low-income Americans. Beginning on Jan. 1, 2014, the ACA will provide Medicaid coverage to all individuals under age 65 with incomes up to 133 percent of the federal poverty level ($14,484 for an individual or $29,726 for a family of four in 2011). This change in Medicaid eligibility is estimated to expand coverage to an additional 16 million individuals.

Federal Appeals Court Upholds Health Reform's Insurance Mandate

No Author — Tue, 19 Jul 2011 10:00:00 EST

The U.S. Court of Appeals for the 6th Circuit, based in Cincinnati, ruled that the decision by Congress to require Americans to buy healthcare insurance in 2014 or face a fine was legal under the Commerce Clause of the U.S. Constitution.

'The provision regulates active participation in the healthcare market, and, in any case, the Constitution imposes no categorical bar on regulating inactivity. Thus, the [individual mandate] provision is a valid exercise of Congress's authority under the Commerce Clause, and the decision of the district court is affirmed.'

Featured News - Federal Health Reform News RSS Feed