Health Care Fraud and Abuse Laws Affecting Medicare and Medicaid: An Overview

Health Care Fraud and Abuse Laws Affecting Medicare and Medicaid: An Overview

Date: September 8, 2014
Creator: Staman, Jennifer A.
Description: This report provides an overview of some of the more commonly used federal statutes used to fight health care fraud and abuse and discusses some of the changes made to these statutes by the Patient Protection and Affordable Care Act (ACA).
Contributing Partner: UNT Libraries Government Documents Department
The False Claims Act, the Allison Engine Decision, and Possible Effects on Health Care Fraud Enforcement

The False Claims Act, the Allison Engine Decision, and Possible Effects on Health Care Fraud Enforcement

Date: November 6, 2008
Creator: Staman, Jennifer
Description: The False Claims Act (FCA), an important tool for combating fraud against the U.S. government, generally provides that a person who knowingly submits, or causes to be submitted, a false or fraudulent claim for payment to the U.S. government may be subject to civil penalties and damages. This report provides an overview of the FCA and the Allison Engine decision, analyzes how this decision could affect certain FCA health care claims, and discusses the proposed False Claims Correction Acts (S. 2041 and H.R. 4854), which, if enacted, could limit the application of the Allison Engine decision.
Contributing Partner: UNT Libraries Government Documents Department
NFIB v. Sebelius: Constitutionality of the Individual Mandate

NFIB v. Sebelius: Constitutionality of the Individual Mandate

Date: September 3, 2012
Creator: Lunder, Erika K. & Staman, Jennifer
Description: Report that provides an overview of the Court's holding with respect to the individual mandate of the Patient Protection and Affordable Care Act (ACA) under the Commerce Clause and the Taxing Power. It also addresses possible implications of the decision on existing federal law and future legislation.
Contributing Partner: UNT Libraries Government Documents Department
Employment-Based Health Coverage and Health Reform: Selected Legal Considerations

Employment-Based Health Coverage and Health Reform: Selected Legal Considerations

Date: June 12, 2009
Creator: Staman, Jennifer & Liu, Edward C.
Description: It is estimated that nearly 170 million individuals have employer-based health coverage. As part of a comprehensive health care reform effort, there has been support (including from the Obama Administration) in enacting comprehensive health insurance reform that retains the employer-based system. This report presents selected legal considerations inherent in amending two of the primary federal laws governing employer-sponsored health care: the Employee Retirement Income Security Act (ERISA) and the Internal Revenue Code (IRC).
Contributing Partner: UNT Libraries Government Documents Department
Legal Issues Relating to State Health Care Regulation: ERISA Preemption and Fair Share Laws

Legal Issues Relating to State Health Care Regulation: ERISA Preemption and Fair Share Laws

Date: August 26, 2008
Creator: Shimabukuro, Jon O. & Staman, Jennifer
Description: This report provides an overview of the Employee Retirement Income Security Act (ERISA) preemption, discusses legal challenges to fair share laws, and analyzes the fair share requirements included as part of the Massachusetts Health Care Reform Act.
Contributing Partner: UNT Libraries Government Documents Department
Cash Balance Pension Plans: Selected Legal Issues

Cash Balance Pension Plans: Selected Legal Issues

Date: July 29, 2005
Creator: Lunder, Erika & Staman, Jennifer
Description: Over the past few years, cash balance pension plans have received significant attention. In particular, three issues have been controversial: the negative effect of a plan conversion on older employees due to wear-away, the whipsaw effect that may occur when computing a lump-sum payment of benefits prior to normal retirement age, and the claim that these plans violate federal laws prohibiting age discrimination. This report discusses the wear-away and whipsaw issues, a proposal by the Treasury Department that addresses them, and relevant legislation introduced in the 109th Congress (H.R. 2830 and S. 1304).
Contributing Partner: UNT Libraries Government Documents Department
Premium Tax Credits and Federal Health Insurance Exchanges: Questions and Answers

Premium Tax Credits and Federal Health Insurance Exchanges: Questions and Answers

Date: December 19, 2014
Creator: Staman, Jennifer A.; Lunder, Erika K. & Shedd, Daniel T.
Description: Legal challenges that may have a substantial impact on the implementation and operation of the Patient Protection and Affordable Care Act (ACA) concern whether premium tax credits are available for millions of individuals participating in federally administered health insurance exchanges. The Supreme Court has decided to weigh in on this issue in King v. Burwell. This report provides background on provisions of ACA relevant to this issue. It then answers questions concerning the legal challenges and potential implications of the Court's decision in King.
Contributing Partner: UNT Libraries Government Documents Department