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How does Jessie Zeigler anticipate the intersection of privacy and smart technology will impact the future of litigation? Find out more>

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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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Healthcare Private Equity Compliance Checklist

The complex and ever-changing healthcare regulatory and enforcement environment, including increased focus on the role of private equity firms in their portfolio companies, make compliance a top priority for private equity firms investing in healthcare companies. The best way to limit your exposure as a private equity firm is to avoid a compliance misstep in the first place. Additionally, an effective and robust compliance program for your portfolio healthcare company makes it much more attractive to potential buyers and helps you avoid an unexpected and costly investigation or valuation hit down the road. Download the Healthcare Private Equity Compliance Checklist to assess whether your portfolio company's compliance program is up-to-date.

Click here to download the checklist.

DOL Suspends March 23, 2012 Due Date for Distribution of Summary of Benefits and Coverage

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November 18, 2011

On November 17, the Department of Labor ("DOL"), with the assistance of the Departments of Treasury and Health and Human Services, provided welcomed (albeit ambiguous) relief regarding the new Summary of Benefits and Coverage ("SBC") required to be distributed by group health plans and health insurance issuers ("insurers") subject to the requirements of the Affordable Care Act. (We described the availability of the proposed SBC template on page two of our Health Reform Impact alert issued on October 5, available here.)

Until this DOL announcement, the deadline for initially distributing the SBC was to be March 23, 2012. However, the DOL's newest set (Part VII) of Frequently Asked Questions About Affordable Care Act Implementation (available here), describes that compliance with the SBC requirements will be not be required until an applicability date to be announced in forthcoming final regulations on the subject. Although the DOL did not provide—or even hint at—a particular date, the DOL anticipates that this applicability date (i.e., including the initial SBC distribution deadline) will give plans and insurers "sufficient time to comply" with the SBC requirements.

This DOL announcement similarly suspends the requirement that group health plans and insurers provide 60 days' prior notice of any "material modifications" in the terms of the plan or coverage described in the most recently issued SBC.

We await further guidance from the DOL on the SBC applicability date, and will keep you informed of any developments.

If you have any questions about this issue of Health Reform IMPACT, please contact any of the attorneys in our Employee Benefits Practice Group.


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