Insights

American Rescue Plan Act COBRA Subsidies

On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021 (“ARPA”), which includes provisions for COBRA subsidies that will apply to self-funded and fully insured plans, multi-employer plans and governmental employer plans. T… Read More
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Categories: Healthcare

Medicaid Work Requirements

On February 12, 2021, the Biden Administration made its first move to revoke approval for Medicaid work requirements. CMS Acting Administrator Elizabeth Richter sent a letter to the eight (8) states that had previously received approval for a Section… Read More
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Categories: Healthcare

Executive Order on Strengthening Medicaid and the Affordable Care Act

On January 28, 2021, President Biden released an executive order titled Executive Order on Strengthening Medicaid and the Affordable Care Act, stating that a goal of his administration will be to increase the accessibility of high-quality healthcare… Read More
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Categories: Healthcare

CMS Releases Rule to Streamline Prior Authorizations and Ease Exchange of Health Information

On January 15, 2021, the Centers for Medicare and Medicaid Services (CMS) released a final rule, the CMS Interoperability and Prior Authorization Rule, to streamline prior authorization and patient and provider access to medical records. The rule req… Read More
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Categories: Healthcare

AHA v. Azar

On December 29, 2020, the U.S. Court of Appeals for the D.C. Circuit issued an opinion in American Hospital Association, et al., v. Azar, affirming the district court’s decision to uphold the rule that requires hospitals to disclose negotiated… Read More
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Categories: Healthcare

Trump Administration Releases Final Rule Requiring Insurers to Disclose Prices

On October 29, 2020, the Department of Health and Human Services, the Department of Labor and the Department of Treasury issued a final rule that requires group health plans and health insurers to disclose cost-sharing information to participants and… Read More
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Categories: Healthcare

9th Circuit of Appeals Rules that Anthem Must Cover ER Visits

The U.S. Court of Appeals for the 9th Circuit recently ruled in the case Martin Luther King, Jr., Community Hospital v. Community Insurance Company, d/b/a Anthem Blue Cross and Blue Shield, et al. The District Court previously granted summary judgeme… Read More
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Categories: Healthcare

CMS Approves Georgia and Nebraska Medicaid Expansion with Work Requirements

On October 15, 2020, CMS approved an 1115 Waiver for Georgia called the Georgia Pathways to Coverage demonstration, which will partially expand Medicaid and impose premiums and work requirements on beneficiaries. The demonstration expands Medicaid co… Read More
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Categories: Healthcare

Atrium Health and Wake Forest Baptist Finalize Merger

Charlotte, N.C. based Atrium Health completed its merger with Winston-Salem, N.C. based Wake Forest Baptist Heath on October 9, 2020, and will continue to operate under the Atrium Health name. The merger created a 42-hospital system, employing more t… Read More
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Advocate Aurora and Beaumont Health Cancel Merger

Beaumont Health, based in Southfield, MI and Advocate Aurora, with dual-headquarters in Downers Grove, IL and Milwaukee, WI, have ended their merger discussions. The parties had signed a non-binding letter of intent in June of this year announcing th… Read More
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