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July 25, 2014

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In This Issue
Draft Employer Reporting Forms Are Finally Here!
Two Courts, One Law and No Change...Yet
Ways & Means Subcommittee Hearing Highlights GAO Report on Lack of Subsidy Enrollment Controls
House Panel Advances Employer Mandate Lawsuit Against President Obama
HHS Gets a New Senior Counselor
Contraception Battle Continues
Free Compliance Corner Webinar for NAHU Members on August 7
What We’re Reading
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Draft Employer Reporting Forms Are Finally Here!

The forms we have been long awaiting to finalize implementation and compliance with the individual and employer mandates are here, just without proper instructions. Seriously. On Thursday evening, the Internal Revenue Service (IRS) released draft forms for employer reporting, the small business tax credit, healthcare coverage exemptions and the premium tax credit that employers will have to fill out to prove that they are in compliance with the health reform law’s employer mandate. The draft forms, however, were released without instructions, so it’s still a little unclear how the IRS will ultimately want these forms submitted. The department did say that the instructions will be out by the Fall... Read More

Two Courts, One Law and No Change...Yet

On Tuesday, July 22, two federal courts released diametrically opposed rulings regarding the availability of subsidies in federally facilitated marketplaces. In a 2-1 decision in the Halbig v. Burwell case, the U.S. Court of Appeals for the D.C. Circuit determined that the IRS and the federally facilitated exchange marketplace was not authorized to distribute premium tax credit subsidies to individual exchange consumers. The court determined that the Patient Protection and Affordable Care Act (PPACA) “unambiguously restricts” the availability of subsidies to insurance purchased in state-based exchanges, and that the IRS regulation acted outside of the parameters of the PPACA by making available subsides via the federally facilitated and partnership exchanges. Hours later, the 4th Circuit Court of Appeals in Richmond released an unanimous decision (3-0) in King v. Burwell that the IRS has acted correctly in allowing tax subsidies to be issued via all federal and state-run exchange states... Read More

Ways & Means Subcommittee Hearing Highlights GAO Report on Lack of Subsidy Enrollment Controls

On Wednesday, July 23, the House Ways and Means Committee’s Subcommittee on Oversight held a hearing about the integrity of the health reform law’s premium tax credit. The hearing’s sole witness was Seto Bagdoyan, the acting director of audit services, forensic audits and investigative service for the federal Government Accountability Office (GAO). Bagdoyan reported for the first time on the preliminary results of an ongoing federal investigation of the controls being used by the federal health insurance exchange when deeming individuals eligible for federal premium tax credit subsidies. The GAO’s investigators found that so far in 11 of 12 attempts made in several different states, undercover agents were able to enroll in subsidized insurance coverage using entirely fake applications. Bagdoyan stressed that the investigation results were preliminary and an ongoing investigation’s initial results shouldn’t be taken out of context. However, he also noted that the findings to-date raise “a number of questions that are fundamental about the effectiveness of controls.”... Read More

House Panel Advances Employer Mandate Lawsuit Against President Obama
On Thursday, July 24, the House Rules Committee approved a resolution that would authorize a lawsuit by the House of Representatives initiated by Speaker John Boehner's (R-OH) lawsuit against President Obama regarding the use of executive power in the Administration’s delay of the employer mandate... Read More
HHS Gets a New Senior Counselor
Shortly after Sylvia Matthews Burwell was sworn in as secretary of the Department of Health and Human Services (HHS) she announced that two new, senior level positions were being created to strengthen the department’s leadership team and enhance the department’s ability to implement the health reform law. This week, Secretary Burwell announced that Leslie Dach, a former Wal-Mart executive, will be joining the HHS team as a senior counselor. Dach comes to HHS with 25 years of business experience, seven of which he served as the executive vice president of corporate affairs for Wal-Mart Stores Inc. Burwell and Dach have a professional history; they first worked together during the 1988 Michael Dukakis campaign and again later at the Wal-Mart Foundation... Read More
Contraception Battle Continues

The Obama Administration, in a court document filed in the U.S. Court of Appeals for the 10th Circuit this week, has announced that it will be creating a new option for certain religious non-profits that object to both the PPACA contraception mandate and the Administration’s previous efforts to find accommodations for them. The announcement comes in response to the recent Supreme Court decision that ruled that Wheaton College, a religious institution and non-profit, did not have to provide contraception in employee health plans while the overall issue of a non-profit's ability to request a contraception exemption makes its way through the courts. These legal issues are separate from the Supremes’ recent Hobby Lobby contraception ruling, where the high court decided that certain family-owned for-profit businesses did not have to provide birth control in employee health plans if it violated their religious beliefs. The Court has not yet made a decision on how this applies to religious non-profit organizations. The health reform law, as it is written today, only grants contraception exemptions for religious institutions of a certain tax code, hence the variety of different organizations seeking exemptions from the court... Read More

Free Compliance Corner Webinar for NAHU Members on August 7
Did you know that since 2009 there have been over 100 million dollars in fines levied against health insurance carriers, hospitals, physicians and other parties over HIPAA Privacy and Security requirements? The percent of those fines attributable to lost or stolen computer data, or even not properly disposing of an old computer, is truly scary. And recently, the Obama Administration has announced their intent to conduct thousands of audits of both covered entities and business associates in the next year to ensure compliance. Since agents, brokers and consultants are liable for similar breaches along with a whole set of new rules as business associates for their group clients and various health insurance companies, you have a much higher standard to meet... Read More
What We’re Reading

We are about to scoot out to the pool and enjoy some splash time with our three favorite swimmers. A magazine might be in our bag, but we plan to ignore it. Summer is slipping by and we highly recommend that you spend some time soaking up the sun with your loves this weekend too. But we did check out every link below over the past work week and if you have a few free minutes, we hope you enjoy clicking away!... Read More

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