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News Archive


CMS Releases Final "60 Day Rule"
Today, the Centers for Medicare & Medicaid Services (CMS) released the final version of a 2012 proposed rule that requires Medicare Parts A and B health care providers and suppliers to report and return overpayments by the later of the date that is "60 days after the date an overpayment was identified, or the due date of any corresponding cost report if applicable." Read more>>

NCD Releases 2nd Report on ACA and Disability
On January 26, 2016, the National Council on Disability (NCD) released a report entitled "The Impact of the Affordable Care Act: A 2015 Status Report." This is the second in a series of three reports that examines the provisions in the Affordable Care Act (ACA) that affect the lives of people with disabilities. Read more>>​
 
The National Council on Disability Releases Report on ACA and Disability
Last week, the National Council on Disability (NCD) released a report entitled “Implementing the Affordable Care Act: A Roadmap for People with Disabilities.”  This is the first in a series of three reports that examines the provisions in the Affordable Care Act (ACA) that affect the lives of people with disabilities. Read more>>​

 
Employer Shared Responsibility
 
Kaiser Family Foundation Releases Infographic on Employer-Sponsored Health Insurance
On May 3, the Kaiser Family Foundation (KFF), in partnership with the Journal of the American Medical Association (JAMA), released a Visualizing Health Policy infographic that looks at eligibility and coverage trends in employer-sponsored health insurance. Read more>> 
 
Six Things to Know about the Employer Shared Responsibility Provisions
On March 16, 2016 the IRS released a health care tax tip entitled, “Six Things to Know about the Employer Shared Responsibility Provisions.” The article states that the “health care law includes the employer shared responsibility provisions, which require applicable large employers to offer health coverage to full-time employees and their dependents. Read more>>

IRS 1095-C Forms are Due to Employees by March 31
All applicable large employers – employers with 50 or more full-time employees, including full-time equivalents – must provide their employees with the new mandatory form 1095-C by March 31, 2016.  These requirements apply regardless of whether health coverage was offered to employees. Read more>>
 
Need Help With Filing Your IRS Forms 1094 & 1095?
If you are an Applicable Large Employer (ALE) with fewer than 250 employees and need help with your 1094 and 1095 form filings, AHCA Insurance Solutions is here to help! The 1094 and 1095 reporting requirements apply regardless of whether health coverage was offered to employees. Read more>>
 

Be Compliant: Know Your Workforce Numbers
The Internal Revenue Service issued another reminder last week to employers about the importance of knowing the exact size of their workforce under the Affordable Care Act (ACA).This is essential because two provisions of the ACA apply only to applicable large employers – those employers with 50 or more employees in the previous calendar year. Read more>>​

IRS Extends Deadlines for New Mandatory Forms for Employers with 50 or more FTEs
The Internal Revenue Service has extended the deadlines for new mandatory forms that must be completed by an applicable large employer – employers with 50 or more full-time employees, including full-time equivalents. The new deadline for the first of these new reporting requirements is now March 31, 2016 which is an extension of nearly two months from the previous deadline. Read more>>​

Average Individual Mandate Penalty Could Jump 47 Percent in 2016
A new analysis from the Kaiser Family Foundation finds that the average penalty for uninsured people who are eligible for an Affordable Care Act (ACA) marketplace plan will rise to $969 per household – 47 percent higher than the $661 estimated average for 2015.  Read more>>
 

It's Not Too Late to Avoid ACA Penalties in 2016
Under the Affordable Care Act, certain employers - called applicable large employers (ALE) - are subject to the employer shared responsibility provisions. If you are an ALE, you may choose to offer affordable minimum essential coverage in order to avoid penalties of $2,000 per full-time employee (minus the first 30 full-time employees). Read more>>

  
Health Insurance Marketplaces

CMS Finalizes ACA Marketplace 2017 Rule
The Centers for Medicare & Medicaid Services (CMS) has released a Factsheet  and Final Rule, Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2017, a “sweeping rule,” to ensure that the Affordable Care Act (ACA) Marketplace continues to work smoothly. Read more>>
Congress Postpones the ACA’s “Cadillac Tax” Until 2020

At the close of the first session of the 114th Congress, lawmakers approved a massive spending and tax package that included a postponement of the Affordable Care Act’s so-called “Cadillac Tax” until 2020.   The tax was scheduled to take effect in 2018. Read more>>​


 

SHOP Marketplace Application
According to a January 11, 2016, email from the Centers for Medicare & Medicaid Services (CMS), if you submit your initial group enrollment Small Business Health Options Program (SHOP) Marketplace application and make your initial payment by January 15 -- your coverage can be in place as early as February 1. Read more>>

New Features of SHOP Marketplace for 2016
On Tuesday, January 5, 2016, the Centers for Medicare and Medicaid Services(CMS) sent out an email noting new features in the Small Business Health Options Program (SHOP) Marketplace for 2016.  To see what’s new, read more >>

CMS Proposes Changes to the Affordable Care Act
According to a November 21, 2015, Inside Health Policy article written by Amy Lotven, on Friday, November 20, the Centers for Medicare & Medicaid (CMS) “proposed wide-ranging changes to the Affordable Care Act's exchange plans and related policies for 2017, including standardizing plan offerings by metal level, requiring states to select minimum network adequacy standards, counting out-of-network charges toward the maximum limits, changing the risk adjustment methodology and adding new options for the Small Business Health Options Program. Read more>>
 
ACA Reviews
The OIG has created a new webpage with reviews of the health insurance exchanges and other Medicare, Medicaid, and public health programs. The reviews are focused on promoting the economy, efficiency, and effectiveness of Affordable Care Act (ACA) programs across HHS. Read more>>  
 
Final Rule Designed to Improve ACA Marketplace Consumer Information
The Departments of Labor, Health and Human Services (HHS), and the Treasury have issued final regulations that make it easier for people and employers to compare options when shopping for and renewing health insurance coverage. Read more>>  
 
Legal
 
US Supreme Court Rules in Favor of ACA Subsidies
The U.S. Supreme Court issued its decision in King v. Burwell, finding in favor of the Obama Administration, and voting 6-3 to uphold the Affordable Care Act's (ACA) subsidies in states that have a federally-run exchange. Read more>>​
 
 
State Innovation Waivers
 
Government Issues New ACA Waiver Guidance
On December 16, 2015, the US Department of Health and Human Services (HHS) and the Department of the Treasury issued new guidance for states interested in seeking a State Innovation Waiver under section 1332 of the Affordable Care Act (ACA). The guidance provides states with flexibility to pursue innovative waiver proposals while preserving the important protections of the ACA. Read more>>
ACA State Innovation Waivers
Section 1332 of the Affordable Care Act (ACA) permits a state to apply for a State Innovation Waiver to pursue innovative strategies for providing their residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA.  State Innovation Waivers allow states to implement innovative ways to provide access to quality health care that is at least as comprehensive and affordable as would be provided absent the waiver. Read more>>  

CMS Proposes Changes to the Affordable Care Act
According to a November 21, 2015, Inside Health Policy article written by Amy Lotven, on Friday, November 20, the Centers for Medicare & Medicaid (CMS) “proposed wide-ranging changes to the Affordable Care Act's exchange plans and related policies for 2017, including standardizing plan offerings by metal level, requiring states to select minimum network adequacy standards, counting out-of-network charges toward the maximum limits, changing the risk adjustment methodology and adding new options for the Small Business Health Options Program. Read more>>

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