Health Law Monitor

INDIVIDUAL HEALTH INSURANCE MANDATE UNDER PPACA RULED UNCONSTITUTIONAL

    A federal judge in Virginia has ruled that the individual health insurance mandate contained in the nation’s new health reform legislation is unconstitutional.

Virginia Judge Holds Individual
Health Insurance Mandate Unconstitutional

    The nation’s new health care reform legislation consisting of the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act (collectively "PPACA") took a legal hit this week. On Monday, a Virginia federal judge held that the individual health insurance mandate was unconstitutional.

    In Commonwealth of Virginia v. Sebelius, United States District Judge Henry Hudson held that the individual mandate exceeds Congress’ power to regulate economic activity under the Commerce Clause of the United States Constitution. Hudson, a Bush appointee, stated in his opinion that “[n]either the Supreme Court nor any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market.” The Judge limited his decision to the individual mandate and declined to strike down the entire PPACA legislation or even issue an injunction against enforcement of the individual insurance mandate.

    The legal battle over the individual mandate is far from over; two other federal judges, one in Michigan and one in Virginia, have upheld its constitutionality, and twelve other challenges have been dismissed on procedural grounds. Later this week, a federal judge in Florida will hear arguments in a challenge brought by 20 state attorneys general and a number of governors. The Florida case is the broadest challenge thus far as it challenges other provisions of PPACA in addition to the individual mandate. We will keep you apprised of further developments as this issue moves forward. A United States Supreme Court review of the issue is very likely in the coming months.

CMS Announces Cut in Physician Reimbursement Rates and Changes to Supervision Requirements for Outpatient Services

CMS issued the 2011 Medicare Physician Fee Schedule final rule, which cuts physician reimbursement by 24.9% between November 2010 and January 2011. Additionally, CMS recently released its 2011 Outpatient Prospective Payment System final rule setting forth several changes to physician supervision requirements for hospital outpatient services to take effect on January 1, 2011.

Health Reform Update - Provider Impact

Health Reform Update

 The third installment of our health reform series focuses on the impact upon health care providers of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act (referred to together herein as “PPACA”).

Health Reform Whitepaper: Employer Impact of PPACA

Health Reform Whitepaper: Employer Impact of PPACA 

The second installment of our Health Reform series focuses upon the impact of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act (referred to together herein as “PPACA”) upon employers and their group health plans. PPACA places a number of requirements upon both existing and new group health plans (including both insured and self-insured plans) that will take effect for plan years beginning on or after September 23, 2010. Hence, for calendar year plans, many of the changes must be in place by January 1, 2011. PPACA also establishes certain employer health insurance play-or-pay mandates commencing in 2014.