Health Law Insider

Developments and trends in the health care industry

Appeals Court ruling supports MA organization request for refund of B&O taxes paid on premiums On April 1, 2019, the Washington Court of Appeals Division 1 ruled unanimously in a published opinion that premiums received by Medicare Advantage (“MA”) organizations from or on behalf of their members are not subject to Washington’s business and occupation (“B&O”) tax. Grp. Health Coop. v. Dep’t of Rev., No. 79091-9-1 (Wn. Ct. App. Apr. 1, 2019). Washington’s B&O tax…
In late January, the U.S. Department of Health and Human Services’ Healthcare & Public Health Sector Coordinating Council issued a new cybersecurity guidance document for healthcare businesses of all sizes. The guidance document, entitled “Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients,” available at https://www.phe.gov/Preparedness/planning/405d/Pages/hic-practices.aspx, provides concrete and practical guidance for addressing what the Council has identified as the “most impactful threats . . . within the industry” and serves as a renewed…
The Washington Law Against Discrimination (WLAD) prohibits “places of public accommodation” from discriminating against their customers on the basis of several protected characteristics, including, without limitation, sex, race, national origin, and sexual orientation. Sexual harassment is one prohibited form of such sex-based discrimination.  Generally speaking, a place of public accommodation is any business that is open to the public. On January 31, 2019, the Washington Supreme Court announced a new sexual harassment standard for places…
Late last year, Congress passed the Tax Cuts and Jobs Act, which included a provision  effectively repealing the requirement for most Americans to have health insurance.  This “individual mandate” was originally imposed by the Affordable Care Act (“ACA”). Beginning in 2019, the tax penalty individuals face if they do not enroll in health coverage considered minimum essential coverage (“MEC”) will drop to zero. For many Americans, the individual mandate was satisfied by the health coverage…
Washington’s Insurance Commissioner Rolls Back Federal Attempt to Expand Access to Short-Term Health Plans On October 17, 2018, the Office of the Insurance Commissioner (“OIC”) adopted a final rule that defines minimum standards for short-term limited-duration health insurance plans (“short-term plans”) in Washington State and rejects federal efforts to expand their availability. Short-term plans are exempt from many of the minimum requirements applicable to most health plans under the Affordable Care Act (“ACA”) and Washington…
Angle v Board of Dentistry, No. A162472, decided by the Oregon Court of Appeals on October 17, 2018, is a statutory interpretation case that may inform how dentists respond to requests for information from the Oregon Board of Dentistry. ORS 679.170(6) provides that no person shall “fail to respond” to a written request from the Board of Dentistry for information.  Does a “nonresponsive” reply count as a failure to respond?  In this case, the…
The Office of Civil Rights (OCR) announced in a press release this week that Anthem, Inc. (Anthem), one of the nation’s largest health benefit companies, has agreed to pay $16 million and take substantial corrective action to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules. This settlement is the largest in HIPAA-enforcement history, far exceeding the previous record of $5.5 million paid by Memorial Healthcare in 2017.…
The Oregon Division of Financial Regulation (the “Division”) recently issued a bulletin clarifying Oregon law and guidance applicable to association health plans (“AHPs”), which are multiple employer welfare arrangements (“MEWAs”) under ERISA. In Bulletin No. DFR 2018-07 (the “Bulletin”), the Division declined to adopt the more flexible criteria established by the recent U.S. Department of Labor (“DOL”) final regulation on AHPs (the “AHP Rule”). The AHP Rule modified the definition of “employer” under ERISA to…
Health care lawyers have long debated whether the AKS safe harbor provides full protection for employees who are paid to market a supplier’s services.  In Carrel v. AIDS Healthcare Foundation, 898 F.3d 1267 (Aug. 7, 2018), the Eleventh Circuit might have come a step closer to answering this question.  The Carrel court affirmed the dismissal of a False Claims Act suit against the AIDS Healthcare Foundation, Inc. (the “Foundation”), holding that the Anti-Kickback Statute (“AKS”)…
Welcome to Stoel Rives’ newest blog: Health Law Insider. Health Law Insider will provide insights from our team of experts on the full spectrum of legal issues that are shaping the health care industry, including data privacy and security, fraud and abuse, health care transactions, antitrust, taxation, and insurance regulation. The health care delivery system is in the midst of a transformation. While the end state is unknown, it is almost certain to involve greater…