Tag Archives: affordable care act

CMS Finalizes Rules Regarding Eligibility for Medicare Prescription Drug Subsidy

On January 17, 2012 the Centers for Medicare & Medicaid Services (“CMS”) adopted as a final rule changing Medicare’s Extra Help Program. The Extra Help Program is a prescription drug coverage low-income subsidy created through the Affordable Care Act (“ACA”). Effective January 18, 2012, the final rule incorporates the ACA’s changes to the Extra Help Program by extending eligibility for one year after the death of a beneficiary’s spouse that would otherwise decrease or eliminate the subsidy. The final rule also implements changes to the Medicare Improvements for Patients and Provider Act of 2008 by excluding from a resource (for purposes of Extra Help eligibility) the value of life insurance policies or income for food, shelter, and certain household bills.

Read the full notice from the federal register here.

CMS Now Allows Physician Assistants to Perform Skilled Nursing Facility Level of Care Certifications and Recertifications

On January 13, 2012 CMS issued Transmittal 153, implementing section 3108 of the Affordable Care Act which now allows physician assistants to perform level of care certifications and recertifications in skilled nursing facilities. The physician assistant may perform the certification or recertification if the physician assistant collaborates with the physician but does not have a direct or indirect employment relationship with the facility. The new transmittal will be implemented on February 13, 2012 and the changes will be effective with items and services furnished on or after January 1, 2011.

Read CMS’ full transmittal here.

United States Supreme Court to Hear Affordable Care Act Cases

vIn a highly anticipated decision, on November 14, 2011 the United States Supreme Court granted certiorari in three cases on the constitutionality of the Affordable Care Act (“ACA”): National Federation of Independent Business v. Kathleen Sebelius, Secretary of HHS, et al.; Florida, et al. v. Department of Health and Human Services; and Department of Health & Human Services et al. v. Florida, et al. The Court’s review will address four fundamental questions: (1) whether the ACA’s individual mandate is constitutional, (2) whether the individual mandate may be severed from the ACA if it is unconstitutional, (3) whether the claim brought by the opponents to the mandate is barred by another federal statute, and (4) whether the ACA’s expansion to Medicaid coverage was valid. The Court has granted a total of four and a half hours of oral argument for the three issues, which is highly unusual. This decision will be monumental for the future of the ACA, and will be closely followed by Duane Morris attorneys.

View the United States Supreme Court’s order here.