The Patient Protection and Affordable Care Act of 2010 (ACA) affects many constituencies.  

Health care providers, health plans, state governments, consumers, among many others, are required to comply with the ACA's provisions.  Even before the ACA passed in March 2010, Ice Miller actively tracked its evolution and advised clients on its potential effects.  Our work began as early as Fall 2009 with seminars and client briefings on the various bills that were being considered and how they might affect our clients.
After the ACA was enacted, we immediately started advising clients on both the immediate and potential long-term impacts of the Act.  Since then, Ice Miller has presented dozens of speeches and seminars educating its clients and potential clients about the ACA and has published dozens of articles and alerts on the various components of the ACA.
Ice Miller's work on the ACA focuses on its effects on health care providers, medical device companies, employer group health plans and health insurance exchanges.  

Representative Experience

Experience with Providers:
  • Education sessions with providers including Board presentations and general educational sessions
  • Advise on specific aspects of the ACA affecting providers, such as accountable care organization regulations, physician sunshine provisions, physician owned hospital provisions and health insurance exchange provisions
  • Fraud and abuse and reimbursement changes under the ACA
  • Compliance with the Physician Sunshine Act provisions
  • Review payor agreements under health insurance marketplace
Experience with Employer Health Plans under ACA:
  • Advise clients on whether their health plans could and should maintain "grandfathered" status under the ACA and the consequences for failing to do so
  • Advise employer health plans how to implement certain mandated benefits such as coverage for dependent children under age 26, the elimination of pre-existing condition limitations, the modification and elimination of annual and lifetime dollar limits on essential health benefits, first-dollar coverage for preventive care benefits, and expanded claims and appeal rights
  • Assist clients with modifying their health plan designs and amend plan documents to comply with the Act
  • Complete full-scale analyses of health plans for compliance with the ACA's coverage mandates and revise plan documents to ensure documentary compliance
  • Discuss with clients the potential assessments they could face for not providing health coverage to certain employees or for providing substandard coverage
  • Work with employers to help them understand how to determine the employees to whom they must provide coverage to avoid assessments and to discuss workforce restructurings
  • Advise clients about health insurance exchanges and how employers might leverage these exchanges in providing health coverage to their employees
Here are a few specific examples of the extensive work we have done with employer-based health plans:
  • Performed a comprehensive review for a 32,000-employee/24-hospital health care system that involved reviewing multiple health plans for ACA compliance, amending all of those plans for the ACA's coverage mandates, and advising on day-to-day implementation questions
  • Analyzed the retiree-only exception under the ACA that exempts retiree health plans from a substantial portion of the ACA's requirements for several state-wide employee retiree health plans, as well as several large for-profit employers
  • Helped several small employers plan for 2014 and the implementation of the health insurance exchanges to help them understand their options for providing employee health insurance and the potential penalties for failing to do so
  • Advised an international specialty chemical company on the ACA's effects on its benefit plans and have drafted multiple plan documents and amendments to ensure compliance
  • Worked with both private employers and state-wide public employee retiree health plans to help them apply for and obtain reimbursements from the Early Retiree Reinsurance Program which enabled them to collectively receive millions of dollars in reimbursements to help sustain retiree health coverage
  • Advised multiple employers on the ACA's requirement that employers report the value of group health plan coverage on employees' Forms W-2


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