Month: March 2023

The IRS has announced the 2024 employer mandate penalties under the Affordable Care Act for employers with 50 or more full-time equivalent employees. Under the ACA, employers may be subject to an employer mandate penalty for (1) failing to offer minimum essential coverage to 95% of full-time employees (A Penalty) or (2) offering coverage that is not affordable (B Penalty).

According to Statista, nearly half of Californians (48.1% in 2021) get their health insurance through their job. The percentage in Nevada is slightly less – at 45.9%. The Kaiser Family Foundation (KFF) found in its 24th Employer Health Benefits Survey (EHBS) in 2022 that the average annual premiums for employer-sponsored health insurance was $7,911 for single coverage and $22,463 for family coverage.

The Consolidated Appropriations Act (CAA) Rx Data Collection (RxDC) component requires health plans/issuers to produce and file reports on prescription drug and health care spending for the 2022 calendar year by 6/1/2023. These reports are due annually and will be due by June 1st each year thereafter.

Courts at the state and federal levels continue grappling with the application of California insurance law to COVID-19 business interruption claims. Much uncertainty remains as to how California law applies in a number of scenarios presented by the pandemic.

A U.S. lawmaker is taking action after a KHN investigation exposed weaknesses in the federal system meant to stop repeat Medicare and Medicaid fraud and abuse. Rep. Lloyd Doggett (D-Texas) said he decided to introduce a bill in the House late last week after KHN’s reporting revealed what he called a “shocking loophole.” “The ability of fraudsters ...

The U.S. Justice Department has dismissed its own appeal challenging UnitedHealth Group’s (UNH.N) nearly $8 billion acquisition last year of Change Healthcare, a court filing showed. The healthcare deal was seen as a blow to the Biden administration’s tougher enforcement of antitrust issues. The Justice Department had argued the deal would give UnitedHealth, the largest U.S. health ...

Gov. Gavin Newsom, whose administration is struggling to contain a worsening homelessness crisis despite record spending, is trying something bold: tapping federal health care funding to cover rent for homeless people and those at risk of losing their housing. States are barred from using federal Medicaid dollars to pay directly for rent, but California’s governor is ...

The Biden administration’s decision to end the covid-19 public health emergency in May will institute sweeping changes across the health care system that go far beyond many people having to pay more for covid tests. In response to the pandemic, the federal government in 2020 suspended many of its rules on how care is delivered. That transformed ...

A collection of nearly 30 provider groups wants the Biden administration to combine fee-for-service and prospective payments to primary care doctors to bolster the workforce. The groups wrote a letter to officials with the (PDF) Centers for Medicare & Medicaid Services (CMS) on the need for such a hybrid payment model. The missive comes as CMS has ...

California has hit another major milestone in its fight against COVID-19, with all of the state’s residents now living in areas with a “low” community transmission level for the first time since last fall. This puts California’s 58 counties in line with approximately 93% of others across the U.S. that meet the Centers for Disease Control ...