Final Rule and Updates to Non-discrimination Regulations of the ACA
The Department of Health and Human Services (“HHS”) finalized revised regulations that implemented Section 1557 of the Affordable Care Act (“ACA”) in June of 2020. This section prohibits discrimination within health programs and activities receiving federal financial assistance based on race, color, sex, age, disability, and national origin. In comparison to the Obama-era regulations issued in 2016, the new final rule does away with gender identity and sexual orientation nondiscrimination protections not only under Section 1557, but under ten other federal regulations as well. This also includes a roll back of certain health insurance coverage protections for transgender individuals.
The Constitutionality of the ACA: California v. Texas
Signed by President Obama on March 23, 2010, The Affordable Care Act (“ACA”) provided a monumental change to healthcare. The ACA created access, added provisions to improve quality, and created cost containment measures. However, the ACA created a quintessential question of Federalism. As it exists today, the Supreme Court will listen to oral arguments in November on the constitutionality of the ACA, in California v. Texas. If the Court decides that the ACA is unconstitutional, millions of Americans who are insured under the Act will lose coverage. Additionally, aside from access, the ACA includes regulatory laws such as Section 1557’s nondiscriminatory provisions, and amendments to the False Claims Act & HIPAA.
CMS Launched Pilot Project to Offer Individual Market Wellness Programs
Workplace wellness programs — efforts to get workers to lose weight, eat better, stress less and sleep more — are an $8 billion industry in the U.S. Recently, Centers for Medicare and Medicaid Services (CMS) launched a pilot project for states to implement health-contingent wellness programs in the individual market. The project is part of a mandate under the Affordable Care Act that added a provision to the Public Health Service Act calling for health-contingent wellness programs to be tested in the individual market through a pilot project operated by HHS, the Department of Labor and the Treasury Department.
OIG Work Plan on Nursing Facility Staffing Levels
In August, the U.S. Department of Health and Human Services (“HHS”) Office of Inspector General (“OIG”) made an additional focus in its Work Plan for the oversight of nursing facility staffing levels. These changes were made in the light of backlash from a July 2018 news article which reported that nearly 1,400 nursing homes had fewer qualified staff on duty than they were required or failed altogether to provide reliable staffing information to the Centers for Medicare and Medicaid Services (“CMS”).
Proposed Public Charge Intended for Immigrants but will Impose on Health Care
Every time we turn on the news, someone is either talking about immigration reform or health care reform. Health care and immigration are two major areas that President Trump promised to address and is attempting to tackle within his first two years in office. Although most would not consider that these two issues would overlap, in today’s American health care system, Americans need immigrants. Immigrants contribute a great deal to our medical research, make up a large percentage of our health care providers, and subsidize health insurance premiums.
Is the ACA Unconstitutional (Again)?
Before the Affordable Care Act (“ACA”) was passed, critics exclaimed that the government had no right to interfere in a citizen’s healthcare. When it was passed, the requirement that every American purchase health insurance caused America to scramble to comply. However, in a year all the critics might be silenced. Recently, Congress repealed the individual mandate’s tax penalty. How will Americans comply with the new act?
Market Giants Move to Redesign Healthcare
In January 2018, Warren Buffet, Jamie Dimon, and Jeff Bezos announced that Berkshire Hathaway, JP Morgan Chase, and Amazon would partner together to form a non-profit company aimed at improving the United State healthcare system and combating ever-increasing costs. The idea for the project came about from the ongoing discussion between the three CEOs regarding providing healthcare for their, collectively, approximately 840,000 employees. Even though details are scarce, given the importance of the issue and the prominent names attached to this project, the press, the public, and the market have reacted accordingly. In other words, people are scrambling to figure out what this might mean for their companies and our healthcare system as a whole.
IRS Ruling Threatens Future of Commercial ACOs, Cost-Reducing Healthcare Providers
Connie Zhang Associate Editor Loyola University Chicago School of Law, JD 2018 Your healthcare may come from an accountable care organization, and you may not even know it. That could soon change now that the IRS has denied one commercial accountable care organization (ACO) the tax-exempt status granted to most nonprofit health care providers. …