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Sanders’ Medicare-for-all, Graham-Cassidy’s block grant legislation introduced in Senate
Two health care proposals were introduced on September 13, 2017, one from a group of Democratic Senators led by Bernie Sanders (I-VT) calling for a single-payer health care system and another from Rep...
IRS should mitigate limitations of BCBS Standard plan on Cadillac tax
The Patient Protection and Affordable Care Act (ACA) will impose a 40-percent excise tax on high-cost employer sponsored coverage (also known as the Cadillac tax). The tax would be imposed when an emp...
Three state marketplaces get an A for verifying applicant eligibility
Three state-based marketplaces used varied data sources to verify applicant eligibility for subsidized coverage and had few indications of potentially improper or fraudulent enrollments for plan year ...
MCO’s sole shareholder unable to recover damages after forced liquidation
A managed care organization’s (MCO) sole shareholder was barred from bringing a suit before the D.C. District Court to recover damages after the D.C. Superior Court allowed a rehabilitation acti...
Question of fact over whether dialysis was an essential health benefit under the ACA
An insurer may be liable for reimbursement of claims for dialysis treatment in 2013 beyond the capped benefit under its plan, because the cap may not have been in compliance with the Patient Protectio...