Ankur J. Goel Ankur J. Goel

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  Ankur J. Goel represents health industry clients in significant compliance, False Claims Act, litigation and regulatory matters. Ankur works with a range of health industry clients. He represents health plans on issues arising under Medicare Advantage, Part D, and health insurance exchanges, as well as health care providers on a variety of complex enforcement, compliance, regulatory and litigation matters. Read Ankur Goel's full bio.

Fifth Circuit Issues ACA Ruling, But Severability Question Remains


By , , and on Dec 26, 2019
Posted In Benefit Controversies, Employee Benefits, Health and Welfare Plans

A decision in Texas v. United States was issued by a divided three-judge panel of the US Court of Appeals for the Fifth Circuit on December 18, 2019. This case presented once again the question whether the Affordable Care Act (ACA) is constitutional and sustainable, and questions of severability remain for the near future. Access...

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CMS Releases Broad-Ranging Medicare Advantage and Part D Proposed Rule


By , and on Dec 26, 2017
Posted In Employee Benefits, Health and Welfare Plans

CMS released a broad-ranging proposed rule for the Medicare Advantage and Part D Programs on Thursday, November 16, 2017. The proposed rule addresses a broad and diverse range of MA and Part D regulatory requirements, affecting not only Medicare Advantage Organizations and Part D Sponsors, but also health care providers, pharmacies, pharmaceutical manufacturers and others....

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CMS Aims to Stabilize Exchanges but Does Not Address Issuers’ Biggest Questions


By , and on May 16, 2017
Posted In Health and Welfare Plans

CMS recently released a final rule with the goal of stabilizing Exchange markets for 2018. The agency also issued several significant guidance documents where CMS extended the deadlines for 2018 rate and Exchange qualified health plan application submissions, adopted a good faith compliance standard for 2018 and delegated additional plan certification responsibilities to states. While...

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Trump Administration Takes First Steps to Support Exchanges, but Key Questions Remain


By , and on Mar 2, 2017
Posted In Health and Welfare Plans

In an effort to stabilize the Exchanges and encourage issuer participation, the Centers for Medicare & Medicaid Services (CMS) recently extended the federal Exchange application and rate filing deadlines and published a proposed rule affecting the individual health insurance market and the Exchanges. While issuers will likely see these actions as encouraging signs of the...

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How Congress, President-Elect Trump Might Proceed on Promise to Repeal, Replace ACA


By , and on Nov 14, 2016
Posted In Health and Welfare Plans

President-elect Donald Trump has vowed to repeal and replace the Affordable Care Act (ACA). This campaign promise, which echoes a familiar refrain from Republicans since ACA’s passage, is more complex than it may seem. There are pathways to quickly “repealing” key elements of ACA such as the individual mandate and its subsidies, but this could...

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Federal Court Strikes Down ACA Cost Sharing Reduction Payments


By on May 26, 2016
Posted In Employee Benefits, Health and Welfare Plans

Last week, a federal district court ruled that US Congress did not appropriate funds for the cost-sharing reduction subsidies in the Affordable Care Act. The court stayed the decision pending an anticipated appeal to the US Court of Appeals for the District of Columbia Circuit. Read the full article. 

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King v. Burwell Decision Upholds Subsidies in Federal Exchanges


By , , and on Jul 2, 2015
Posted In Benefit Controversies, Employee Benefits, Fiduciary and Investment Issues, Health and Welfare Plans, Labor

On June 25, 2015, the Supreme Court of the United States ruled in King v. Burwell that the Affordable Care Act (ACA) requires premium tax credits to be made available in states that use a federal exchange. The case challenged an Internal Revenue Service (IRS) regulation allowing tax credits in federal exchanges. The Supreme Court upheld the...

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U.S. Appeals Courts Issue Conflicting Decisions on Whether ACA Permits Tax Subsidies of Health Care Coverage Purchased Through Federal Exchanges


By , , , and on Jul 29, 2014
Posted In Health and Welfare Plans

The U.S. Court of Appeals for the District of Columbia struck down the Internal Revenue Service (IRS) rule providing for federal tax credits for health insurance purchased through federal exchanges, while the U.S. Court of Appeals for the Fourth Circuit upheld the same IRS rule. If en banc review in the appeals courts does not...

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2015 Notice of Benefit and Payment Parameters


By , and on Apr 3, 2014
Posted In Health and Welfare Plans

The Centers for Medicare & Medicaid Services’ Final Notice of Benefit and Payment Parameters for 2015 contains numerous alterations to premium stabilization programs, cost-sharing requirements and employee counting provisions to account for lower-than-anticipated enrollment through the Exchanges and the Obama Administration’s decision to permit individuals to “keep their current plan” through 2016.  All of these...

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