On February 15, 2017, the IRS announced on its website that, based upon its review of the White House’s January 20, 2017, executive order, it would continue to accept returns filed by taxpayers that do not report whether the taxpayer has complied with the individual mandate of the Affordable Care Act. Individual taxpayers are required to report on their returns whether they have health insurance coverage, qualify for an exemption to the coverage requirement, or are making a shared responsibility payment. Previously, the IRS had made changes to its software that processes tax returns so that returns filed without these sections completed would be automatically rejected and treated as not filed. Now, those returns will be treated as filed, and the missing information will be addressed by the IRS. Continue Reading IRS announces changes to individual mandate enforcement
The Department of Health and Human Services Office of Inspector General (OIG) recently implemented a new safe harbor to the federal Anti-Kickback Statute and beneficiary inducement statute, which went into effect on January 6, 2017.1 The new safe harbor, which was published by the OIG in a final rule dated December 7, 2016,2 protects the provision of free or discounted local transportation by eligible entities to Medicare or Medicaid beneficiaries, provided that certain conditions are met. While non-compliance with the safe harbor does not necessarily mean that a transportation arrangement will violate the Anti-Kickback Statute, children’s hospitals should take note of the safe harbor requirements and assess whether any of their existing transportation arrangements should be restructured. Continue Reading New Local Transportation Safe Harbor to the Anti-Kickback Statute and Beneficiary Inducement Statute
Even without potential changes to the Medicare program, MACRA poses a significant challenge for any clinician trying to determine the best strategy to maximize Medicare reimbursement – there are hundreds of pages of guidance in the proposed and final regulations to review and understand. But, at this point, clinicians attempting to assess MACRA must also deal with uncertainty about changes to the Medicare program. A significant source of uncertainty is the Trump administration’s stated intent to repeal the Affordable Care Act (“ACA” and also known as Obamacare), which is being implemented by current legislative efforts. Uncertainty about the ACA should be considered in developing a strategy to comply with MACRA. Continue Reading Managing MACRA – Part VII: What happens to MACRA if the Affordable Care Act is repealed?
On January 6, 2017, several new regulatory exceptions to the beneficiary inducement statute went into effect. These regulations, published by the Department of Health and Human Services Office of Inspector General (OIG) in a final rule dated December 7, 2016,1 bring long awaited closure to many of the outstanding issues raised in the statutory versions of the exceptions implemented by the Affordable Care Act (ACA) and in the proposed regulations issued by the OIG on October 3, 2014.2 Several exceptions that may be of particular interest to children’s hospitals are highlighted below. Continue Reading New Regulatory Exceptions to the Beneficiary Inducement Statute
This is the fourth article in our series on the effect of the “slow repeal” of the ACA. This week’s article starts a three-part discussion on the potential impact of the slow repeal of the ACA on the health insurance industry, with this week’s focus on the individual health insurance market.
On February 2, 2017, an important House Subcommittee – the Energy and Commerce Health Subcommittee – began addressing four bills that address portions of the ACA. Although three of the four bills were introduced in previous years, all four measures come at a time when lawmakers are grappling with the impact of “repeal and replace” – or just “repeal” – on the increasingly fragile individual health insurance markets. Continue Reading Slow Repeal of the ACA and Its Impact on the Individual Health Insurance Industry
Emerging Issues in Healthcare Law is coming to the Big Easy. The American Bar Association’s 18th annual conference is slated for New Orleans March 8-11.
Husch Blackwell is a platinum sponsor of this event featuring the most emergent topics facing the healthcare bar. As the industry faces changes and continues to grow under healthcare reform and enforcement, this conference allows attendees a perfect opportunity to stay ahead of the developments. Continue Reading Don’t miss Emerging Issues in Healthcare Law
With the nomination of Judge Neil Gorsuch of the United States Court of Appeals for the Tenth Circuit to the United States Supreme Court, much of the conversation in coming days and weeks will be about his views on abortion, free speech, and his stated skepticism regarding the Chevron doctrine. But his opinion in a recent tax case allows a glimpse into his views on another issue that may come before the Court – the split between the growing number of states which have legalized marijuana and the its continued illegality under federal law. Continue Reading Gorsuch, marijuana and taxes
President Trump’s nominee for Secretary of the Department of Health & Human Services (HHS), Congressman Tom Price (R-Ga.), has now completed two confirmation hearings in the Senate. If confirmed, Rep. Price will direct more than $1 trillion of annual spending, as well as assist in developing and implementing a replacement for the Affordable Care Act (ACA). First, the Senate Committee on Health, Education, Labor & Pensions (HELP) held a courtesy hearing January 18, and then the Senate Finance Committee, which has jurisdiction over the nomination, held its hearing January 24. The following is a summary of what we learned – or did not learn – over the course of those hearings. Continue Reading Tom Price Confirmation Hearings – What We Have Learned?
Specialists are generally subject to the MACRA merit-based incentive payment system (MIPS) in the same manner as primary care clinicians but are treated differently under MACRA in two situations:
- Certain specialists may qualify as “non-patient-facing” (for example, pathologists or radiologists that do generally not see patients) and have reduced MIPS reporting obligations; and
- A specialist who participates in more than one alternative payment model (APM) will receive the most favorable APM treatment of the APMs in which the specialist participates (for example, if the specialist participates in two Track 1 ACOs, the specialist will get the higher of the MIPS scores for those ACOs).
The 2017 National Defense Authorization Act, Pub. L. No. 114-328 (Dec. 23, 2016), introduces major changes to the Defense Department healthcare program known as TRICARE. By this time next year, we’ll see a new program to contain the cost of prescription drugs at retail pharmacies, contractual incentives for improving the quality of healthcare and reducing “per-capita cost,” and the first major step toward privatizing the delivery of healthcare to military members.