POLICY BRIEFINGS


Supreme Court Review of Legality of Certain Individual Tax Subsidies


As previously reported, the U.S. Supreme Court granted a petition for certiorari in the King v. Burwell case in which the U.S. Court of Appeals for the District of Columbia Circuit held that the IRS did not adhere to the black letter of the health care law when it ruled that individuals who buy health insurance on the federal HealthCare.gov exchange are eligible for tax credit subsidies even though they reside in states electing not to establish their own health insurance exchanges. As a result of the action by the Supreme Court, the U.S. Court of Appeals for the District of Columbia Circuit granted a motion to hold in abeyance the case Halbig vs. Burwell which was previously scheduled for an en banc hearing by the lower court. States like Illinois and Delaware that do not operate their own state-run health insurance exchanges (but may assume partial responsibilities) will have to make major changes if the Supreme Court invalidates the IRS regulation.


Court of Appeals Rules in Favor of PPACA Accommodation


The U.S. Court of Appeals for the District of Columbia Circuit ruled that the final PPACA regulations providing accommodation for nonprofit religious organizations that object to providing contraceptive coverage to their employees doesn’t violate the Religious Freedom Restoration Act. The court said the final women’s preventive services regulations do not significantly burden the free religious exercise rights of Priests for Life and similarly situated organizations because it doesn’t require the organizations to do anything other than self-certify that they are nonprofit religious groups that object to contraceptive coverage on religious grounds.


Ebola Drives HIPAA Relief


The HHS Office of Civil Rights issued a bulletin stating that protected health information under the Health Insurance Portability and Accountability Act (HIPAA) may be disclosed without a patient’s permission in public health emergency situations, such as the ongoing Ebola outbreak. HHS said that the HIPAA Privacy Rule “protects the privacy of patients’ health information (protected health information) but is balanced to ensure that appropriate uses and disclosures of the information still may be made when necessary to treat a patient, to protect the nation’s public health, and for other critical purposes.”


MACPAC Seeks Comments on Transition from CHIP to Alternative Coverage


The Medicaid and CHIP Payment and Access Commission (MACPAC) is asking for comments by December 19 on matters which would allow for seamless coverage from CHIP to other coverage such as Medicaid and PPACA plans.


CMS Notice Sets Forth Ambulance Preauthorization Trial


CMS announced that the agency will require prior authorization in New Jersey, Pennsylvania and South Carolina for non-emergency ambulance services that are typically covered by Medicare.


Proposed Medicare Coverage for Certain Imaging Services


CMS released a proposed decision memo that, if finalized, would provide for the institution of Medicare coverage for low-dose imaging to screen people at high risk for lung cancer. Comments are due by December 10.



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