Supreme Court Sets Dates for Oral Argument on Challenges to Health Care Law
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- Published on Wednesday, 21 December 2011 18:25
The U.S. Supreme Court recently announced that it has set the date for oral arguments on the health care reform law for March 26-28, 2012. Attorneys will have five-and-a-half hours over three days in which to argue specific questions related to the controversial law, known as the Patient Protection and Affordable Care Act. The health care law, which was signed into law in March 2010, is intended to expand the number of Americans who have access to health insurance coverage. Decisions in the lower courts regarding the health care law have been split. In the largest of the lawsuits, the attorneys general of 26 states, led by Florida, filed suit against the federal government over the health insurance mandate. These states argue that the required health insurance is a product that individuals may not want or need. The federal government argues that all Americans need medical care at some point, and uninsured individuals incur billions in uncompensated costs that insurers must pass on to their covered customers. At the Supreme Court, several consolidated lawsuits (Department of Health and Human Services v. Florida; National Federation of Independent Business v. Sebelius; and Florida v. Department of Health and Human Services ) seek decisions on legal challenges regarding the requirement that all individuals have a minimum level of health insurance or pay a tax penalty and questions around federal powers to force states to expand Medicaid eligibility and thus incur tremendous costs. The Supreme Court is considering four legal questions to be argued for a set time over the three days: (1) Whether the Anti-Injunction Act bars the lawsuit that challenges the insurance coverage mandate before it goes into effect in 2014 (1 hour); (2) Whether Congress has the power under Article 1 of the Constitution, or the commerce clause, to regulate economic inactivity in order to mandate minimum coverage (2 hours); (3) Whether Congress exceeded its powers in mandating minimum coverage, and if so, is the law in its entirety invalidated or to what extent can the individual mandate be separated from the remainder of the law; (4) Whether Congress exceeded its powers by forcing states to accept an expansion of Medicaid costs and administration under pain of losing Medicaid funding (1 hour). It is likely that the Supreme Court will render its decision during the summer of 2012. Read More.
DOL Proposes Rules to Regulate MEWAs
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- Published on Monday, 05 December 2011 22:24
The U.S. Department of Labor's (DOL) Employee Benefits Security Administration today announced two proposed rules under the Affordable Care Act intended to protect businesses and employees whose health benefits are provided through a multiple employer welfare arrangement (MEWA). Through MEWAs, unrelated employers, typically small businesses, seek to provide health care benefits to employees at what is represented to be lower costs than other traditional forms of coverage. However, according to the DOL, the promoters, marketers and operators of MEWAs often take advantage of gaps in the law to avoid state insurance regulations, such as a requirement to maintain sufficient funding and adequate reserves to pay the health care claims of employees and their families. In some cases, employees incur significant medical bills before they learn that claims are not being paid — and that they are liable and need to pay their medical bills themselves. For employers or employee organizations that have paid premiums or made contributions to an MEWA, the impact can thus be significant. The DOL’s proposed rules call for MEWAs to adhere to enhanced reporting requirements so that employers, workers and their families will not unexpectedly be cut off from health care services. The rules also will increase the DOL’s enforcement authority to protect participants in such plans and allow the department to shut down MEWAs engaged in fraud or other activities presenting an immediate danger to the public safety or welfare. Secretary of Labor Hilda L. Solis commented that, "Too many MEWAs are taking advantage of good employers who want to make health insurance available to their workers, and too many hardworking Americans have suffered…These proposed rules under the Affordable Care Act will crack down on those who want to use MEWAs to defraud American families." Read More.
Proposal Revealed for Calculating Full-time Employees Under PPACA
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- Published on Thursday, 05 May 2011 16:32
The U.S. Treasury Department unveiled a proposal on how to determine whether an employee is full-time pursuant to the health care reform law requirement that employers offer full-time employees coverage or pay a penalty if they do not. Beginning in 2014, pursuant to the Patient Protection and Affordable Care Act, employers with at least 50 full-time employeescurrently defined as employees who work an average of at least 30 hours per weekmust offer coverage or pay an annual assessment of $2,000 for each full-time employee not offered. The Treasury Department is now seeking public comment on determining whether an employee meets the 30-hour threshold. Under one plan suggested by the Treasury Department in Notice 2011-36, an employer would calculate each employee's full-time status by looking back "at a defined period of not less than three but not more than 12 consecutive calendar months" to determine if the employee worked an average of 30 hours per work during this "measurement" period. If the employee met the 30-hour standard by that measurement, the employee would be considered full-time during a subsequent "stability" period, regardless of the number of hours worked by the employee during that subsequent period. For an employee meeting this threshold, the stability period would be at least six consecutive months after the measurement period. If an employee did not meet the criteria for full time status during the measurement period, the employer would be able to exclude the individual in calculating its full-time employees during a stability period....
Court Finds No FEHA Violation Because Employer Properly Engaged in the Interactive Process
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- Published on Friday, 29 April 2011 19:15
The Department of Fair Employment and Housing ("DFEH") and Steven J. Carauddo appealed a district court's grant of summary judgment in favor of Lucent Technologies, Inc. ("Lucent"), Carauddo's former employer. Carauddo claimed that Lucent terminated him in violation of the California Fair Employment and Housing Act ("FEHA"). In addition, the DFEH challenged the district court's finding of diversity jurisdiction. Carauddo worked as a telecommunications installer for Western Electric, Lucent's predecessor. An installers duties consist mostly of physical functions such as running cable, drilling holes, setting frames and wiring cell cabinets. These activities require an installer to be able to lift and maneuver items over 30 pounds. While performing his job, Carauddo suffered a back injury and took a medical leave of absence beginning in January of 2005. In these situations, Lucent requires that a member of their medical department, usually a nurse, stay in communication with the employee throughout the disability period. Over the next few months, Lucent received varied work restrictions from Carauddo's health care provider that ranged from no bending, twisting and lifting over 10 pounds to occasionally lift or carry weights from 21 to 50 pounds. Lucent sought clarification from the medical provider and then advised Carauddo that the work restrictions could not be accommodated. Eventually, Carauddo was terminated on January 25, 2006. In March of 2006, Carauddo was cleared by his physician to return to work with no restrictions. When Lucent did not reemploy Carauddo, he filed a complaint with the DFEH. The district court held that during the disability period Lucent communicated frequently with Carruddo, that "Lucent reasonably accommodated Carruddo, and that DFEH failed to establish that Lucent's legitimate reason for terminating him was merely pretextual."...
Senator Boxer Reintroduces Legislation to Expand COBRA
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- Published on Wednesday, 06 April 2011 06:02
U.S. Senator Barbara Boxer (D-CA) has reintroduced legislation known as the Equal Access to COBRA Act, which would provide many domestic partners with the same access married spouses currently have to COBRA health coverage if their partner loses a job. According to information posted on Senator Boxer's website, "The law would apply to companies that already offer health coverage to domestic partners and their children. Currently, more than half of Fortune 500 companies cover domestic partners under their health plans." Senator Boxer commented on the proposed legislation, stating that "All of our families deserve equal access to health insurance. This bill would help ensure that domestic partners and their families will be able to keep their health coverage if their partner loses their job." Under federal law, employers must offer continuing health care coverage to departing employees and their beneficiaries for up to 36 months, depending on the circumstances. However, current federal laws pertaining to COBRA coverage do not apply to domestic partners or same-sex spouses even if the employer offers health coverage to domestic partners of employees. This proposed legislation would change federal law to allow equal access to COBRA coverage for all individuals who are covered by an employer's health plan, and it would apply to domestic partners as they are defined by an employer's health insurance plan. However, the legislation would only apply to employers that already offer health care coverage to domestic partners and their children. Senator Boxer originally introduced the legislation last year. Rep. Anthony Weiner (D-NY) has introduced a companion bill in the House. In California, if Cal-COBRA applies, domestic partners are treated the same as spouses....
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