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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Thought Leadership

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Thought Leadership Spotlight

Healthcare Transactions: Year in Review 2018Last year, CVS Health Corp. (NYSE: CVS) announced it would purchase health insurer Aetna Inc. (NYSE: AET) for $67.5 billion, a transaction that would be one of the biggest healthcare mergers in the past decade. The transaction raises an intriguing question: is this the beginning of a transformational shift in healthcare?

Recently, members of our healthcare group authored the Healthcare Transactions: Year in Review outlining 2017 M&A activity and drivers in the following hot healthcare sectors:

• Managed Care
• Hospitals
• Post-Acute Care—Home Health & Hospice
• Ambulatory Surgery Centers (ASCs)
• Healthcare Information Technology (HIT)
• Behavioral Health
• Physician Practice Management

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Deadline to Amend Plans For Over-the-Counter Reimbursement and 2012 HSA and HDHP Limits

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June 8, 2011
June 30th Deadline to Amend Plans For Reimbursement of Over-the-Counter Drugs

Under the Patient Protection and Affordable Care Act, as amended (health reform), health care flexible spending arrangements (health FSAs) and health reimbursement arrangements (HRAs) may not reimburse expenses for "medicines" or "drugs" (other than insulin) purchased without a prescription. Although the change is effective for purchases made on or after January 1, 2011, IRS last year granted employers an extra six months to amend their plan documents. The June 30 deadline is fast approaching, and plans should be amended to reflect this new requirement. The amendment should not be confused with a separate amendment, required by the end of 2012, limiting annual salary reduction contributions to health FSAs to no more than $2,500 beginning in 2013. IRS has also indicated that regulations finalizing the proposed cafeteria plan regulations issued in 2007 are forthcoming. In the meantime, plan documents should accurately reflect any optional features offered under the plan (e.g., grace periods or HSA contributions).

IRS Announces 2012 HSA and HDHP Limits

For calendar year 2012, the limit on pre-tax contributions that individuals may make to a health savings account (HSA) will increase to $3,100 (for self-only coverage) and $6,250 (for family coverage). This represents increases of $50 and $100, respectively, from the 2011 limits.

The limit on annual out-of-pocket expenses under an accompanying high deductible health plan (HDHP) for 2012 is $6,050 (for self-only overage) and $12,100 (for family coverage), representing increases of $100 and $200 from 2011. Minimum annual deductibles for coverage under an HDHP remain unchanged at $1,200 for self-only coverage and $2,400 for family coverage.

Affected plan documents will need to be amended, and summary plan descriptions and participant communications updated, before the new limits go into effect.

If you have questions regarding this Alert, please contact any of the attorneys in our Employee Benefits Practice Group.

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