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Compliance

This section focuses on health care compliance and regulations – both national and state – including the ACA. It includes changes in health care law, regulation, and court decisions and their impact on health insurance professionals, employers, and individuals.

A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal

As shopping season opens for Affordable Care Act plans in some states, customers are confronting staggering costs for their health insurance next year. The extra federal subsidies put in place in 2021 that made coverage more affordable for millions of people will expire at the end of this year unless a gridlocked and idle Congress acts.

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Mark Cuban To Post Full Health Provider Contracts, Says It’s Key To Real Transparency

Mark Cuban, the billionaire entrepreneur and “Shark Tank” alumnus who started Mark Cuban Cost Plus Drugs, told senators on Wednesday that he thinks price transparency is critical to helping employers bring down the cost of health benefits. But Cuban said his Dallas-based online discount pharmacy is using its deep knowledge of health care pricing and ...

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California Hospitals Are Suing Over The State’s Efforts To Curb Their Spending

Hospitals argue that spending caps imposed by an affordability office will result in layoffs, cuts in health care services and reduced access to care for Californians.

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It’s ‘Too Late’ To Extend ACA Subsidies Without Major Disruptions, Some States And Lawmakers Say

States are worried Congress missed its opportunity to extend enhanced ACA subsidies and lower premiums before consumers start picking plans in a few weeks.

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Newly Passed California Laws Tackle Prior Authorization, Private Equity In Care And More

Changes to prior authorization, charity care screening and corporate influence in medicine are on the way for Californian healthcare organizations. Among the dozens of bills signed this week by Gov. Gavin Newsom ahead of an Oct. 12 deadline were several outlining new requirements or broader enforcement of healthcare practices. The new laws, as well as ...

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AstraZeneca Makes Deal With White House to Lower Drug Prices

AstraZeneca became the second drugmaker to enter a deal with the Trump administration to offer lower prices to Medicaid and to offer some of its drugs at a discount through TrumpRx, a government website to facilitate sales directly to consumers. “In other words the lowest price anywhere in the world, that’s what we get,” President Trump ...

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Small Employers To Be Hit Hardest As Federal Health Coverage Rolls Back

The government health program fights in Washington could hit small employers hard, because government programs provide health benefits for 19% of their workers. Medicaid covers 5% of all U.S. workers and 11% of workers at employers with fewer than 50 employees, according to a Commonwealth Fund survey results posted Thursday. Individual and family plans purchased through the ...

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Vance Says ACA Tax Credits Fuel Fraud

Vice President Vance said Sunday that subsidies offered under the Affordable Care Act (ACA) fuel waste and fraud in the insurance industry, as Republicans refuse Democratic demands to extend the tax credits ahead of open enrollment next month. “The tax credits go to some people deservedly. And we think the tax credits actually go to a lot of waste ...

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IRS Publishes 2026 Benefits Parameters For Cafeteria Plans, Health Reimbursement Plans

Fortunetellers already know how U.S. benefits professionals will spend some of their time from now through mid-2027: They will keep searching the internet for the minimum numbers, maximum numbers and other numbers that shape how the tax breaks for health benefits and other benefits work in 2026. The Internal Revenue Service publishes several batches of ...

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Doctors Cancel Telehealth Appointments As Medicare Coverage Lapses

Health care providers across the country are canceling telehealth visits with Medicare beneficiaries or warning patients they will have to pay out of pocket for appointments because Congress let coverage lapse. When government funding expired Sept. 30, so did several health care policies mostly involving payments, and among them are provisions that allowed Medicare to ...

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