Justices Debate Minimum Coverage Severability

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Justices Debate Minimum Coverage Severability

HealthImaging published an update today regarding PPACA that quotes Paul D. Clement.  “If the individual mandate is unconstitutional, then the rest of the Act cannot stand. If you do not have the individual mandate to force people into the market then community rating and guaranteed-issue will cause the cost of premiums to skyrocket.”

Community rating is something that the industry has now but the data set and sample size is smaller than PPACA contemplates.  In our opinion, guaranteed issue is a component that should be considered by the Supreme Court and preserved or rescinded with the individual mandate.

Edwin Kneedler argued on behalf of the Obama Administration that if the minimum coverage provision should fall, the guaranteed-issue and community rating rules should fall as well as “that is one package that Congress deemed essential.”

Key notes:

American Recovery and Reinvestment Act of 2009 and HITECH Act are separate from PPACA, therefore Meaningful Use will Stand if PPACA is rescinded.

HIPAA Mandate ICD-10 is Separate from PPACA and will Stand if PPACA is rescinded.

Read more here

Justices end PPACA arguments debating minimum coverage severability.

Severability

SCOTUS Coverage Needs a More Holistic View

 

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By | 2017-05-04T04:06:50+00:00 March 28th, 2012|health care reform|0 Comments

About the Author:

Michael is Managing Partner & CEO of No World Borders, a leading health care management and IT consulting firm. He leads a team that provides Cybersecurity best practices for healthcare clients, ICD-10 Consulting, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, Insurance Fraud, payor-provider disputes, and consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $4 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, Stanford Medical School - Biomedical Informatics, Harvard Law School - Bioethics.
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