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The Courts

September 11, 2013 | Health Reform Insider

The top Republicans on the House Ways & Means and Senate Finance Committees on Tuesday (Sept. 10) questioned the legality of what they describe as a potential "carve-out" for union members that would allow multi-employer plan enrollees to receive ACA exchange subsidies. In a letter to Treasury Secretary Jack Lew, the lawmakers criticized several groups' efforts, including many prominent unions, to get the administration to designate multi-employer plans as qualified health plans (QHPs), which would allow enrollees to be eligible for the subsidies.

December 03, 2012 | Daily News

The Supreme Court will hear two key cases related to the biotechnology and generic drug industries, with the high court deciding Friday (Nov. 30) to review Association for Molecular Pathology v. Myriad Genetics, a case on gene patenting, and Mutual Pharmaceutical Co. v. Bartlett, a generic drug preemption case.

July 27, 2012 | Daily News

Wisconsin's top health official says he expects there to be litigation if HHS doesn't budge on the controversial Medicaid maintenance of effort requirements, telling Inside Health Policy that attorneys in his state disagree with a recent finding by the Congressional Research Service and signals from HHS that the MOE requirements remain intact despite the high court's ruling that states can opt out of the health law's Medicaid expansion.

July 26, 2012 | Daily News

HHS Secretary Kathleen Sebelius met privately with key hospital groups earlier this week and urged them to convince states to move ahead with the reform law's Medicaid expansion as not doing so would be detrimental to hospitals, but the administration didn't reveal whether the law's hospital payment cuts would still kick in for states that do not expand Medicaid, a hospital lobbyist tells Inside Health Policy.

July 24, 2012 | Daily News

The Congressional Budget Office in its updated cost projections for the health reform law's coverage expansion appears to assume that HHS will let states expand Medicaid below 138 percent of the federal poverty level and still qualify for the law's higher match rate, Washington insiders tell Inside Health Policy, broaching a question that state Medicaid directors and many governors have posed to the administration but one which HHS has not officially answered.

July 23, 2012 | Daily News

Heads of several hospital groups met with HHS Secretary Kathleen Sebelius on Monday (July 23) to discuss Medicaid expansion issues that have emerged as a result of the Supreme Court's ruling, including “the connection between coverage and payment reductions,” according to the American Hospital Association.

July 19, 2012 | Daily News

Key GOP lawmakers have asked HHS Secretary Kathleen Sebelius to provide by the end of the month legislative and policy details on the Medicaid “blended rate” proposal included in the president's fiscal 2013 budget.

July 16, 2012 | Daily News

Republican Governors Association Chair Bob McDonnell (VA) told Inside Health Policy that he and his colleagues were not pleased with CMS' two-page response to the group's detailed list of 30 questions about how the Supreme Court's health law ruling affects health insurance exchanges and Medicaid expansion, adding that the GOP governors will be sending another letter soon, likely this week.

July 13, 2012 | Daily News

The National Association of Public Hospitals and Health Systems (NAPH) worries that up to 30 states could potentially opt-out of the Medicaid expansion, leaving millions uninsured and creating a untenable situation for public hospitals that would still be subject to lower Disproportionate Share Hospital payments.

July 13, 2012 | Daily News

CMS Acting Administrator Marilyn Tavenner says there is no deadline for a state to tell CMS if it plans to expand Medicaid, according to a July 13 letter to Republican Governors Association Chairman Bob McDonnell (VA) that was sent in response to a slew of questions GOP governors sent CMS earlier this week.

July 13, 2012 | Daily News

Washington insiders say the Supreme Court's Medicaid decision could be a neutral or even a plus for the pharmaceutical industry, although the full effect will not be known until it becomes clear how many states will opt out of the health law's Medicaid expansion.

July 13, 2012 | Daily News

Sen. John Rockefeller (D-WV) appealed to the nation's largest seniors group on Thursday to start educating its members about the benefits of Medicaid as states struggle with how to respond to the Supreme Court's decision to essentially make Medicaid expansion voluntary.

July 11, 2012 | Daily News

Despite the focus on governors' positions on the reform law's now voluntary Medicaid expansion, state legislatures may have the chance to approve or deny the expansions and some believe that state Republican governors seeking attention on the national stage may run up against state lawmakers who are focused locally on the needs of those in their districts.

July 11, 2012 | Daily News

HHS will hold four regional forums over the next several weeks where department officials will discuss with states and other stakeholders the next steps in implementing the health reform law, according to a July 10 letter from HHS Secretary Kathleen Sebelius that urges governors to move forward on key ACA provisions such as exchanges and the Medicaid expansion.

July 10, 2012 | Daily News

Republican governors are telling President Obama that it is incumbent upon the administration and drafters of the health reform law to specify how they will address the “significant gap in coverage” that will likely result for low-income individuals if a state opts out of the Medicaid expansion and therefore there are people who can't get Medicaid coverage and do not qualify for premium tax credits for private insurance, according to a July 10 letter from Republican Governors Association Chairman and Virginia Gov. Bob McDonnell.

July 09, 2012 | Daily News

State Medicaid directors have sent a barrage of questions to CMS in a quest for policy direction on key Medicaid expansion issues that have been left unclear by the Supreme Court's recent health reform ruling, including whether a state can do a limited expansion of Medicaid eligibility instead of completely expanding to 133 percent of the federal poverty level as called for by the law, if states can phase-in their expansion to low-income adults beyond 2014, and whether states that previously expanded Medicaid eligibility would be eligible for the law's higher matching rate even if they decide against proceeding with the full expansion.

July 05, 2012 | Daily News

Medicaid managed care plans expect states to move forward with the health reform law's Medicaid expansion even though the Supreme Court's ruling has made it easier for them to opt out, industry lobbyists say, largely because of the sheer amount of money the federal government is offering states to expand their programs.

July 05, 2012 | Daily News

The Supreme Court's decision essentially turning the reform law's Medicaid expansion into an optional expansion for states is raising questions about whether states will still be required starting in 2014 to use the law's new income test based on modified adjusted gross income (MAGI) to determine an individual's eligibility for the program, sources say.

July 03, 2012 | Daily News

White House officials have agreed to meet with members of the retail industry to discuss issues associated with implementation of the health reform law, quickly responding to the industry's July 2 letter urging the administration to immediately release “long overdue” regulations that would allow employers to move forward on the law's requirements.

July 03, 2012 | Daily News

Several sources suggest that the insurance industry's best chance at repealing the health law's premium tax is as part of a comprehensive tax reform debate that is expected at the beginning of the next congressional session.