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Common control or overlapping ownership can change how to identify the "employer" for PPACA purposes

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • August 15 2012

This is the third in a series of Executive Alerts in the Special Health Care Reform Series

Late push to reauthorize CHIP funding this session

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • September 19 2014

Approximately eight million children currently covered by the Children's Health Insurance Program (CHIP) may lose access to their pediatric-specific

Insurer sues out-of-network hospitals for waiving patient's out-of-pocket expenses

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • June 11 2009

Horizon Blue Cross Blue Shield of New Jersey (Horizon) filed separate lawsuits against two out-of-network hospital providers, claiming that both providers were waiving the coinsurance, deductibles and other out-of-pocket expenses that patients were contractually required to pay for out-of-network providers

Medicaid: issues continue to arise following the Supreme Court decision

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • October 12 2012

In the wake of June's Supreme Court opinion on the Patient Protection and Affordable Care Act (PPACA), government officials at the federal and state level and budget analysts have been thinking about implementation and analyzing the impact of the curve ball thrown by Chief Justice John Roberts and the majority of the Court as to implementation of Medicaid expansion

Court applies Kentucky's 15-year statute of limitations for ERISA class action claims to recover benefits due under terms of plan

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • December 1 2011

At present, most employment class actions relate to wage and hour issues, but there are still many (and frequently hugely expensive) ERISA class actions challenging a host of benefits issues

IRS announces delay in nondiscrimination rules for insured medical plans

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • January 7 2011

On December 22, 2010, the Internal Revenue Service released IRS Notice 2011-1 (to be published in the Internal Revenue Bulletin on January 10, 2011) delaying the implementation of new nondiscrimination rules for fully insured medical plans

New rules for group health plans and health insurance issuers relating to coverage of preventive health services without cost sharing

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • July 16 2010

On July 14, 2010, the U.S. Treasury Department, Internal Revenue Service, the Department of Labor’s Employee Benefits Security Administration and the U.S. Department of Health and Human Services issued interim final rules to implement the provisions of the new Patient Protection and Affordable Care Act (“PPACA”) requiring non-grandfathered group health plans and health insurance issuers in the group and individual markets to provide coverage for preventive health services listed in certain recommendations and guidelines without imposing any cost-sharing requirements on covered individuals

Medicaid DSH: little-noticed CMS rule interpretation creates serious financial shortfalls for impacted hospitals

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • December 12 2013

In what may have been a largely unnoticed rule interpretation affecting hospitals that treat a high percentage of children in the Medicaid program

Medicaid DSH calculation -- insurance won't cover the patient's claim; no worries -- relief may be on the way!

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • January 19 2012

CMS recently issued a proposed rule clarifying what constitutes uncompensated care for purposes of the Medicaid disproportionate share hospital (DSH) payment limit

Changing financial landscape for medical debts of the uninsured

  • Baker & Hostetler LLP
  • -
  • USA
  • -
  • June 12 2014

The implementation of the ACA has afforded many with the opportunity to obtain insurance coverage. Despite the opportunity, a large number of