Health Care Reform

Few legislative initiatives have impacted our clients’ businesses and strategies like the Patient Protection and Affordable Care Act (PPACA).  For years, we have been helping our clients understand, strategize, and plan for the opportunities and challenges that major legislative initiatives inevitably bring.  Mintz Levin is exceptionally well-positioned to help clients evaluate how health care reform will affect them, drawing on:

• our strengths in health law and employee benefits

• our presence on Capitol Hill through ML Strategies, our government relations consulting affiliate

• our in-depth experience with the Massachusetts health reform program and similar federal and state initiatives.

Understanding and Shaping the Debate

Mintz Levin’s Health Law and Employee Benefits attorneys and the consultants at ML Strategies have been analyzing, and helping to shape, the current debate on health care reform.  Our Washington-based government relations team is on Capitol Hill every day, gathering information and advocating for our clients’ interests. And because we counsel clients in every sector of the health care industry and employers of all types, we have the ability to predict how discrete provisions of health care reform likely will affect different entities.

Please click here for our insights on health care reform.

Insurance and Employee Benefits

At the center of health care reform are the issues of expanded access to health insurance, individual and employer insurance mandates, and the potential impact on employee benefits such as health savings accounts and COBRA coverage. 

Massachusetts, which was the first state to pass sweeping health insurance reform legislation, became the principal focus of attention during the national health care reform debate, and reforms at the federal level will draw on key components of the Massachusetts system. Mintz Levin participated in all aspects of the Massachusetts initiative from its inception by assisting with the drafting of the legislation, assessing its impact on the health industry and on employers, determining how ERISA limits a state government’s mandate to offer employees insurance, monitoring activities related to the Medicaid waiver that is a major source of funding for the reform effort, and helping to establish and define the role of the Massachusetts Health Insurance Connector Authority in facilitating the availability of affordable health insurance.

Our Employee Benefits group created a comprehensive guide and advised Massachusetts employers on their new responsibilities.  We are fully prepared to counsel employers as they address insurance and employee benefits provisions under new national regulations.

Reforming Government Programs

Health care reform also will include sweeping changes to government health care programs, especially Medicare and Medicaid.  Two likely areas of change are:

Fraud and Abuse.  Federal and state agencies are already placing increasing emphasis on investigating and prosecuting health care fraud and abuse. Health care reform almost certainly will bring with it heightened scrutiny of those who do business with Medicare, Medicaid, and other state and federal health care programs.  We are prepared to advise health care industry clients on all such changes, which may include a more onerous Medicare enrollment process, mandatory compliance program requirements, more stringent rules related to the return and reporting of Medicare overpayments, a new protocol for self-disclosure of Stark Law violations, and increased civil monetary penalties for program-related violations.    

As the legislative process moves forward, we are advising our clients about what to expect and how to plan to address and comply with new requirements,  and we will be prepared to provide concrete advice as soon as the legislation passes.

Health Care IT.  The health care system cannot reduce costs and become more efficient unless it improves the ways in which it collects and share patient data.  As a result, increased adoption of electronic health record (EHR) systems  and other health care IT initiatives have emerged as an important component of reform efforts. We are already advising clients, both suppliers and adopters, as they implement the requirements of and benefit from pilot programs arising from the American Recovery and Reinvestment Act of 2009 and its component, the Health Information Technology for Economic and Clinical Health (HITECH) Act.  A key provision of the HITECH ACT provides stimulus funding for the widespread implementation of electronic health records (EHR) systems. Mintz Levin is monitoring federal rulemaking related to EHR grants and will be poised to advise on clients on how to qualify for such funding.  We are also addressing the privacy and security issues that are arising from these new health IT initiatives.

The Changing Economic Landscape

Legislation is never enacted in a vacuum, and the impact of health care reform will go well beyond the health care industry.  As the economy strengthens, and the climate for lending and strategic transactions improves, bankers, investors, and others are assessing the business opportunities and limitations that health care reform might create, immediately or in the longer term.  We draw on our analysis of the legislative initiatives and our deep understanding of business drivers in every sector of the health care industry to advise the financial and business community on the potential impact of health care reform.