Nebraska Legislature Adopts Stronger Prescription Drug Monitoring System

by M. Tom Langan, II

A recently adopted law in Nebraska calls for the state to create a prescription drug monitoring system designed to help prevent the misuse of controlled substances, namely prescription pain medicine.  The system will require physicians and pharmacists to enter into a database patient information when prescribing and dispensing certain medications. Patients are not allowed to opt out of the database. A goal is to help prevent so-called “doctor-shopping” – or when a patient visits multiple doctors to obtain multiple prescriptions.

Physicians and pharmacists should be aware that the system is required to be implemented by January 1, 2017.

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HHS Issues Temporary and Proposed Rules on Contraceptive Coverage

The Department of Health and Human Services (“HHS”) has recently issued rules to address the Supreme Court’s recent Hobby Lobby ruling. Under a temporary final rule, religious nonprofit organizations can notify the government of their objection to providing contraceptive coverage for employees, rather than having to authorize the coverage themselves. The government will then arrange for contraceptive coverage. HHS also issued a proposed rule that would extend similar accommodations to closely-held, for-profit religious employers.

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Supreme Court Upholds Individual Mandate

The Supreme Court has upheld the constitutionality of PPACA in a 5-4 ruling issued today.  The Supreme Court determined the individual insurance  mandate was not unconstitutional under the Tax Clause of the Constitution.

A key provision of PPACA was deemed unconstitutional.  Under the Act as originally drafted, the Secretary of Health and Human Services would have had the power to withdraw all Medicaid payments from any state that failed to comply with the expanded Medicaid requirements under the Act.  The Supreme Court held that this provision is unconstitutional.  As a result, the Secretary of Health and Human Services may only withhold funds disbursed under PPACA if a state chooses to participate in the program and fails to comply with its provisions.

The Supreme Court’s ruling underscores the importance of planning for the implementation of PPACA.  Several key provisions of the Act take effect in 2013.  These provisions include Medicare tax increases for individuals earning more than $200,000 per year and married persons filing jointly  earning more than $250,000 per year.  The Act also imposes a $2,500 cap on employee health flexible spending account contributions.  Beginning in 2013, employers will no longer be eligible to take a deduction for providing retiree prescription drug coverage.

Additionally, the comparative effectiveness research fee for employers sponsoring group health plans will increase in 2013.  Employers were previously required to pay a $1 fee for each participant in a sponsored group health plan.  That fee will now double in 2013, and will afterward be indexed to national health expenditures.  Employers will also be subject to additional notification requirements regarding exchange programs.  For example, employers in participating states will be required to provide employees with information about options they may have if the employer’s coverage is not affordable.  In light of the major effects that PPACA will have on group health plans and other related policies, it is crucial for employers to review these plans and policies to make sure that they comply with PPACA provisions coming into force in 2013.

Stay tuned for future blogs and articles about the PPACA once the entire opinion can be digested…

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