ACA Adoption Doesn’t Negate Government-Plan Exclusion, Judge Says

(December 8, 2015, 8:26 AM EST) -- CENTRAL ISLIP, N.Y. — A federal regulation governing the timing and content of benefits determinations clearly applies only to employee-sponsored plans, and its adoption into the Patient Protection and Affordable Care Act (ACA) does not extend its reach to government-sponsored plans, a federal judge in New Jersey held Dec. 4 (Raymond A. Semente, D.C., P.C. v. Empire Healthcare, et al., No. 14-5823, D. N.J.; 2015 U.S. Dist. LEXIS 162941).

(Opinion available. Document #93-151223-004Z.)

Chiropractor Raymond Semente provided out-of-network medical services to Suffolk County, Suffolk County Labor/Management...
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