The ground-breaking health care reform legislation — the Patient Protection and Affordable Care Act — was signed into law in March 2010. This legislation (also commonly referred to as the Affordable Care Act) constitutes a massive overhaul of the United States health care system.
The law puts into place comprehensive health insurance reforms that are intended to increase individuals’ and employers’ access to health coverage, require minimum levels of coverage be available, provide more health care choices, and hold insurance companies more accountable to provide cost-effective coverage. Because of the complexity and ambiguity of the acts, as well as the eight years they are expected to span in implementation, Miller Johnson has formed a Health Care Reform Team to be a resource to our clients.
The attorneys on the Health Care Reform Team come from many of the firm’s well-established practice groups including employee benefits, employment health care, health care providers, provider reimbursement, elder law, and fraud and embezzlement. The team is charged with reviewing and analyzing the legislation as well as monitoring developments. They are committed to informing clients of new regulations as they are released in order to ensure compliance. This communication is accomplished through publications like the Health Care Reform Priority Alert newsletter and our Client Alert emails in addition to webinars and seminars.
For employers, the new laws represent the most significant changes to their health benefit plans since ERISA. So it stands to reason that Miller Johnson attorneys who are dedicated to employee benefits are key players on the Health Care Reform Team. Here are the more important changes to health insurance coverage and employer-sponsored health plans they are monitoring:
Insurance market reforms including greater access for individuals with pre-existing health conditions, more comprehensive coverage of preventive care, extension of dependent coverage to older children, and prohibitions on lifetime and annual limits.
Revenue raisers including those that affect medical FSAs, HSAs, and HRAs in addition to an increase in the Medicare payroll tax, a new premium tax, and an excise tax on the value of “Cadillac” plans.
Pay or Play systems which require states to establish a health insurance “exchange” and provisions which require individuals to enroll in health insurance and employers to offer coverage or pay a penalty.
Administrative requirements such as increased reporting to the federal government and new notices to employees.
The firm’s Health Care Reform Team has a multidisciplinary practice foundation. The breadth of experience and qualifications of the attorney members is at the core of the team’s providing a comprehensive approach to the issue. Other areas of the legislation we will monitor include:
Reporting and compliance is part of the Elder Justice Act and Nursing Home Transparency and Improvement Act, which are included in the new law to help prevent elder abuse and neglect.
In addition to the new requirements in the Nursing Home Transparency and Improvement Act, the legislation includes the CLASS Act, which is a new voluntary payroll deduction program for government-sponsored long-term care insurance.
Employment and labor
Among other issues, employers subject to the FLSA must provide reasonable break time and a private location for nursing mothers.
Fraud and abuse
A goal of PPACA is to reduce waste, fraud and abuse in public programs. This includes significant expansions of the government’s reach under the federal False Claims Act and other civil and criminal laws. The changes consist of increased penalties for submitting false claims, increased funding for anti-fraud activities, and increased government investigations seeking civil and criminal sanctions against health care providers. Medicare: Among the anticipated improvements are expanded programs, changes to Medicare Part D, limits on the amount of civil monetary penalties to be collected from long-term care facilities, faster penalty collections, and modification of payments to hospitals and physicians.
Although a number of revenue-raising provisions will adversely affect employers and taxpayers, such as the increased Medicare payroll tax, there is a tax credit available to small employers which is currently available.
The goal of health care reform is to improve access, quality, and cost-efficiency. The pledge of Miller Johnson’s Health Care Reform Team is to guide and counsel clients on the tremendous impact this will have on their businesses financially and strategically.
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