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Today’s buzz word is Health Care Reform (HCR), and we understand that it takes time to interpret what the law means and determine what implications it has for you.

Building on a year's work in the House and the Senate, President Obama signed two pieces of legislation that will have a lasting impact on individuals and businesses.

  • On March 23, 2010, the Patient Protection and Affordable Health Care Act (H.R. 3590) became law, providing new coverage for millions of Americans and enacting sweeping reforms of the health insurance industry and delivery system.
  • On March 30, 2010, the Health Care and Education Affordability Reconciliation Act of 2010 (H.R. 4872, also known as the “Reconciliation Act”) was signed into law.

The legislation is long and complex, but its major initiatives can be summarized as follows:

  • Provided for increased access to health care services through (1) a combination of mandates, tax credits and subsidies, (2) private health insurance reforms, including new state and federal regulation of private insurance carriers, and (3) enlarging the Medicaid program.
  • Imposed substantial reductions in Medicare payments to providers and suppliers, and an expansion of the tools for public health programs to combat fraud and abuse.
  • Initiated a wide range of demonstration programs and pilot projects to test new methods of health care delivery, many with far-reaching implications for current providers, suppliers and manufacturers.

Clearly, this landmark legislation has serious implications for all stakeholders in our health care system, and we want to help you develop proactive approaches for dealing with the legislation and its aftermath.  Polsinelli Shughart's Public Policy and Health Care groups are no strangers to health care reform.  The firm has been very active in gaining modifications to the legislation for our clients.  Polsinelli Shughart is especially well qualified to assist you in strategic planning and policy analysis of the legislation's provisions, as well as in developing and implementing concrete action steps on regulatory and operational issues to protect your interests, avail yourselves of opportunities that the legislation may present, and to deal with threats where they may exist.

This site is a resource on hot topics and valuable information to help you make informed decisions.


 
Key Resources

If you have specific questions regarding the implications of Health Care Reform, please contact one of our advisors:

Practice Areas
                                        

Team     
               
 
Advocacy and Government Relations     Alan Parver, Team Leader
Steven Stranne
Cynthia Berry
Teresa Brooks
Julius Hobson
Harry Sporidis
Jim Davidson

Martin Frost

 
CMS Reimbursement Advocacy Steve Stranne, Team Leader
Alan Parver
Colleen Faddick
Jennifer Evans

 

Employee Benefits     Brian Johnston, Team Leader
Jamie Zveitel Kwiatek
Michael Conger
  Courtney Brunsfeld
Marsha Woodward
   
Labor and Employment W. Terrence Kilroy, Team Leader
Anthony Romano
Jamie Zveitel Kwiatek
Eric Packel
Judy Yi
    
Insurance Companies Steven Imber, Team Leader
Robert Sullivan
Gerry Brenneman
Jeanie Botkin
Jennifer Osborn
Keith Wenzel
Richard Brownlee
Rodney Gray
   
— Health Insurance Exchanges Teresa Brooks, Team Leader
Robert Sullivan
Steve Imber
Jeanie Botkin
Jennifer Osborn
Martin Frost
   

 — Workers' Compensation

Robert Sullivan
 
Health Care Provider Issues Mary Beth Blake, Team Leader
  Ann McCullough
  Gerald Niederman
Randal Schultz
  Jay Howard
Randy Gerber
Joan Killgore
Janice Anderson
Jane McCahill
Fred Entin
Mark Woodbury
Kara Friedman
  Tom O'Donnell
Robert Sullivan
Alan Parver
Steve Stranne
   
 — Physicians/Physician Groups Randal Schultz
  Bruce Johnson
  Thomas O'Donnell
  Mary Beth Blake
Jay Howard
Randy Gerber
  Julius Hobson
   
 — Long Term Care Matthew Murer
  Charles Sheets
  Jason Lundy
 

 — Tax-Exempt Hospitals

Douglas Anning
 
  Fraud and Abuse Dan Reinberg, Team Leader
Teresa Brooks
  Joan Killgore
  Jeffrey Fitzgerald
Janice Anderson
Jay Howard
   
Life Sciences Kevin Sweeney, Team Leader
  Andrew Hoyne
   
Nonprofit Organizations Bruce Hopkins, Team Leader
  Gerald Niederman
Thomas Schenkelberg
Douglas Anning
Virginia Gross
   
Pharmaceutical and Devices Steven Stranne, Team Leader
Kevin Sweeney
Andrew Hoyne
  Alan Parver
  Colleen Faddick
 
Tax Implications William Sanders, Team Leader
  David Zimmerman
Scott Lindstrom
John Crawford


Useful Web Resources

The following are links to useful resources for further education on Health Care Reform:


 E-Alerts

Overview/Health Reform Information


 

Events to Keep You Informed

  • Event Coming Soon:  Webinar Event - Pilots and Demonstrations in Health Reform Legislation, presented by Polsinelli Shughart Shareholders Janice Anderson, Randal Schultz and Cynthia Berry.  Registration information to follow.
  • June 30: Webinar Event - Health Care Reform: Practical Advice and Creative Solutions - presented by Polsinelli Shughart Shareholder Brian Johnston and representatives of Holmes Murphy.
  • June 14 -15: Event, ChicagoMedical Device Pricing & Reimbursement: Understanding How Proposed Reforms Will Factor Into the Existing Regulatory Schematic.
    Polsinelli Shughart Shareholder Steven K. Stranne helped medical device companies prepare for contemplated changes affecting pricing, reimbursement and payment in the medical device industry at a two-day conference in Chicago hosted by the American Conference Institute.
  • June 9:  Webinar EventA Practical Guide for the Medical Device Community on Health Care Reform - presented by Polsinelli Shughart Shareholders Steven Stranne and Alan Parver. 
  • May 18: Event, New EnglandHealth Care Reform Panel – How Will the New Health Care Reform Legislation Impact Oncology Care in 2010 and Beyond? Northern New England Clinical Oncology Society’s 2010 Spring Practice Management Conference
    Polsinelli Shughart Shareholder Steven K. Stranne provided an overview from the perspective of physician practices of the latest from Washington and moderate an engaging panel discussion with payers and legislative representatives during the Northern New England Clinical Oncology Society's Spring Practice Management Conference.
  • May 18: Event, Kansas CityHealth Care Reform: Practical Advice and Creative Solutions - hosted by Polsinelli Shughart and Holmes Murphy
  • April 29: View a Playback of The Health Care Reform Act and Tax-Exempt Organizations Webinar
    Polsinelli Shughart Shareholders Bruce R. Hopkins and Douglas K. Anning analyzed the new health care reform legislation and share important implications for nonprofit organizations in a special complimentary one-hour Webinar event. 

News

November 11, 2010
April 30, 2010
The Kansas City Business Journal interviews Doug Anning about the Patient Protection and Affordable Care Act that requires nonprofit hospitals to conduct a community health needs assessment at least every three years.

Newsletters & E-Alerts

September 2, 2011
Health Reform + Related Health Policy News for September 2, 2011.
August 19, 2011
Health reform and health policy news for the week of August 15, 2011.
May 13, 2011
The Federal Register published the Final Rule regarding the implementation of the hospital value-based purchasing (VBP) program after the Centers for Medicare & Medicaid Services released the Final Rule in April 2011.  Hospitals must act now if they wish to have the greatest chance at reimbursement under the VBP program.
April 25, 2011
The proposed rule implementing the Medicare Accountable Care Organization (ACO) Program (also referred to as the Shared Services Program) raises many questions and concerns among healthcare stakeholders. 
April 6, 2011
This e-Alert contains a summary of the basic design elements of Accountable Care Organizations (ACOs) as set out in the Centers for Medicare & Medicaid Services proposed rule implementing the Medicare Shared Savings Program.
March 31, 2011
Today the Centers for Medicare and Medicaid Services (CMS) released the proposed rule that will govern the implementation of section 3022 Medicare Shared Savings Program (Program) of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (together referred to as ACA). The Program is intended to promote accountability for a patient population, coordinate care under parts A and B, and encourage investment in infrastructure and care processes that result in the delivery of services through Accountable Care Organizations (ACOs) that meet quality, cost and efficiency metrics.
March 14, 2011
In spite of media stories implying health reform law is well on its way to being “de-funded,” that is not the case. Congress is not repealing health reform legislation. A number of provisions and reductions of funding for programs are in store but the basic structure of the legislation will remain largely intact.
September 2010
September 15, 2010
The Internal Revenue Service has released Notice 2010-59 regarding the reimbursement of over-the-counter medicines and drugs from health flexible spending arrangements (health FSAs), health reimbursement arrangements (HRAs), health savings accounts (HSAs) and Archer Medical Savings Accounts (Archer MSAs) effective January 1, 2011.  Distributions from health FSAs, HRAs, HSAs and Archer MSAs will not be able to reimburse the cost of over-the-counter medicines or drugs unless they are prescribed by a physician. 
August 25, 2010
Although mandates created under the Patient Protection and Affordable Care Act are generally applicable to all group health plans, there are certain compliance exemptions for "grandfathered plans."  Many employers are actually finding the costs of maintaining a grandfathered plan are more significant than the long-term impact of "losing" grandfather status in the process.  The focus of this e-Alert is to identify the advantages and disadvantages of preserving grandfathered status.
June 8, 2010
The popular Polsinelli Shughart Health Care Breakfast Series returns with an opportunity to ask questions of lawyers in the firm's Health Care Law practice.  During the complimentary breakfast event, attendees will gain perspective on how providers are navigating complicated reimbursement issues and creating business opportunities.