The Government Accountability Office (GAO) has provided a status
report on seven states' efforts
to establish health insurance exchanges -- online marketplaces
mandated by the ACA to enable eligible individuals and small
business employers to compare and select health insurance coverage
offered by qualified health plans. States can establish and operate
an exchange themselves or partner with HHS, otherwise HHS will
operate a federally-facilitated exchange for the state. As of March
14, 2013, 18 states had announced they would be establishing a
state-based exchange, 7 states intend to partner with HHS, and HHS
will establish a federally-facilitated exchange in 26 states. The
GAO report provides details on the implementation efforts of the
District of Columbia, Iowa, Minnesota, Nevada, New York, Oregon,
and Rhode Island. Six of the states will operate a state-based
exchange, while the seventh -- Iowa -- will partner with HHS. The
seven selected states expect they will be ready for enrollment by
the October 1, 2013 deadline, with health insurance coverage
effective January 1, 2014. The report addresses the states'
efforts to: decide which QHPs will be included in the exchange;
develop an information technology infrastructure; implement a
consumer outreach and assistance program; and sustain their
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While some may consider improper multiple dependent claims as failing to comply with a mere formality, this case serves as a reminder that a court may consider any statutory requirement when assessing patent validity.
Mintz, Levin, Cohn, Ferris, Glovsky and Popeo, P.C.
While at first pass the case focuses on a small set of insurance policies, this decision could have broader implications on the individual market and further threaten the sustainability of the risk pools.
The Centers for Medicare & Medicaid Services and the Office of Inspector General have reviewed the use of Modifier 25 to unbundle payments for evaluation and management services when a procedure is performed.
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