ABA Health eSource - Your link to the ABA's Health Law Section

Special Edition PPACA

 June 2010
Health Law Section News  June 18, 2010

June 22, 2010
Meaningful Use: What is It? Who Should Obtain It? How to Get Incentive Payments
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June 24, 2010
Physicians and Healthcare Reform: For Better or Worse
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June 29, 2010
Tax Exempt Bonds: Schedule K, Private Use, and Other Compliance Issues
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eSource Chair's Column
By Lisa Atlas Genecov, Locke Lord Bissell & Liddell LLP

By all accounts, the recently enacted Patient Protection and Affordable Care Act (“Affordable Care Act”) is the most broad sweeping legislation to become law in decades. Its impact touches every sector of the U.S. economy and every American family. It will likely take many years to fully understand the impact it will have on our health care delivery systems and our reimbursement mechanisms for the delivery of care.

Given the broad scope and impact of the Affordable Care Act, it is no surprise that its passage has caused a proliferation of articles addressing its various provisions. The ABA Health Law Section’s eSource Editorial Board has received numerous articles on a variety of topics addressed by the Affordable Care Act, to the point that the Editorial Board has decided to create a series of Affordable Care Act Special Editions to keep the ABA Health Law Section members informed on cutting-edge topics important to the health law bar.

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Accountable Care Organizations: With So Many (Unanswered) Questions, Providers and Suppliers Should Start Shaping the Answers Now
By Mark S. Hedberg, Hunton & Williams LLP, Richmond, VA

A recent report indicates that “Medicare officials are preparing to draft regulations for one provision under health reform that policymakers hope will help achieve” a transformation in the method by which hospitals and doctors are paid. The regulations, which will implement the “Medicare Shared Savings Program” created by the Patient Protection and Affordable Care Act (“PPACA”), will be vitally important. As anyone who has attempted to create an accountable care organization (“ACO”) based on PPACA alone well knows, new § 1899 of the Social Security Act (“SSA”) raises many unanswered questions, and until regulations are issued those seeking to structure eligible arrangements are to some extent shooting in the dark.

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Advising the Small Employer on Coverage and Credits
By Don A. Hernandez and Jennifer Tsao, Hernandez Schaedel & Associates, LLP, Pasadena, CA

The recently-enacted Patient Protection and Affordable Care Act (“PPACA”) contains a wide variety of reform provisions intended to make it more affordable for small businesses to offer healthcare coverage to their employees. For example, the legislation provides for the creation of Small Business Health Options Programs (“SHOP”) exchanges, which will be state-run purchasing pools where small employers can band together and utilize their greater purchasing power to buy health insurance at a lower cost. However, small businesses attempting to understand the legislation face a formidable challenge in that each section of the PPACA has its own definition of “small employer.” This one phrase variously refers to entities with anywhere between 1 to 100 employees. But the meaning is critical: whether a business will benefit from tax credits, be penalized for insufficient healthcare coverage, or be able to obtain coverage for its employees in the SHOP exchanges, all depends upon whether it falls into this group.

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Healthcare Reform and Mental Health
By David K. Ries, Human Capital Specialists, Inc., San Diego, CA

Though there are few provisions of the Patient Protection and Affordable Care Act that directly address mental health issues, the sweeping legislation will impact behavioral health care in the United States. The healthcare reform legislation will drive millions of currently-uninsured Americans into managed care and will entitle them to a minimum set of behavioral health care benefits. The legislation’s repeated emphasis on quality-of-care measures and on evidence-based treatment will also increase the need for proven approaches in mental health care. Also, through grants programs and through Medicare and Medicaid spending, the federal government will encourage greater integration of behavioral health treatment into medical care.

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Will the CLASS Act Solve Our Long-term Care Crisis?
By Karen R. Palmersheim, Locke Lord Bissell & Liddell LLP, Los Angeles, CA 

The Patient Protection and Affordable Care Act (“PPACA”) signed into law on March 23, 2010 created a national, voluntary, long-term care insurance program through payroll deduction for active employees through the Community Living Assistance Services and Supports Act -- the CLASS Act. The purpose of the CLASS Act is to assist individuals with functional limitations with maintaining their personal and financial independence to enable them to continue living at home and avoid institutionalized living. The CLASS Act is intended to achieve this goal through providing financial resources to foster independence and to help alleviate the burdens on family caregivers.

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Provider Uncertainties in the Refund of Overpayments
By Neely S. Griffith and Mollye M. Demosthenidy, Jones, Walker, Waechter, Poitevent, Carrère & Denègre L.L.P., New Orleans, LA

The Patient Protection and Affordable Care Act (“Affordable Care Act”), as amended by the Health Care and Education Reconciliation Act of 2010 and the Fraud Enforcement Recovery Act of 2009 (“FERA”), significantly elevated healthcare provider responsibilities for ferreting out and returning payments erroneously received from federal healthcare programs, such as Medicare and Medicaid. This article describes some of the key changes and analyzes the uncertainties and potential pitfalls providers face as a result of these changes in the overpayment refund process.

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Did you know membership in an interest group is FREE with your Health Law Section membership?

Did you know your membership in the ABA Health Law Section qualifies you for free membership in up to three interest groups of your choice? Interest groups, which are comprised of twelve practices areas within health law, make significant contributions to the Section's programming, publications and legislative initiatives. The interest groups also provide an excellent opportunity for you to interact with and have access to some of the most outstanding lawyers in the legal community. You can enroll on our webpage by clicking here. If you have any questions or need more information, please contact Simeon Carson at Simeon.Carson@americanbar.org.

ABA eSource Editorial Board

The ABA Health eSource Editorial Board is led by Chair Lisa Genecov, Locke Lord Bissell and Liddell LLP, Dallas, TX and editorial board members Michael E. Clark, Duane Morris LLP, Houston, TX; Adrienne Dresevic, The Health Law Partners, PC, Southfield, MI; Marla Durben Hirsch, Potomac, MD and Conrad Meyer, Chaffe McCall, LLP, New Orleans, LA.

Do you want to communicate your ideas to thousands of other members? To contribute a newsletter article on a health law topic, send us your ideas to Simeon.Carson@americanbar.org
The opinions expressed are those of the authors and shall not be construed to represent the policies or positions of the ABA or the ABA Health Law Section.
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