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.
The Consolidated Appropriations Act of 2021 created one of the largest transformations in employee health benefits regulation since 1943. It brought with it new transparency requirements, anti-gag clause requirements, broker compensation disclosure rules and more. Two years later, it remains a work in progress.
The U.S. Supreme Court on Thursday bolstered the ability of employees to obtain accommodations at work for their religious practices, reviving a lawsuit by an evangelical Christian former mail carrier accusing the Postal Service of discrimination after being disciplined for refusing to show up for work on Sundays. The 9-0 ruling threw out a lower ...
Millions of pregnant and postpartum workers across the country could be legally entitled to longer breaks, shorter hours and time off for medical appointments and recovery from childbirth beginning Tuesday, when the Pregnant Workers Fairness Act takes effect. The new law mandates that employers with at least 15 employees provide “reasonable accommodations” to workers who ...
The Biden White House announced a trio of steps aimed at protecting patients from unexpected health care costs on Friday, with new actions surrounding short-term health plans, surprise medical bills and medical debt. The Department of Health and Human Services’ proposed rule to limit the scope of short-term health plans would unwind a key Trump ...
Employers in California are not legally responsible for preventing the spread of COVID-19 from their employees to the employees’ family members, the California Supreme Court ruled Thursday. Workers’ compensation laws in the state do not preclude such claims, the court found. But companies also cannot be held legally responsible for preventing such infections, it said, ...
Major players in California’s health care field have reached a deal on how they want the state to spend $19 billion in proceeds of a renewed tax on insurance plans plus the federal funds that go with it — a development that followed months of private negotiations between bitter industry rivals, state lawmakers and the governor’s office.
Federal regulators want most patients to see a health care provider in person before receiving prescriptions for potentially addictive medicines through telehealth — something that hasn’t been required in more than three years. During the covid-19 public health emergency, the Drug Enforcement Administration allowed doctors and other health care providers to prescribe controlled medicine during ...
After Merck and Bristol Myers Squibb took shots at the Inflation Reduction Act (IRA) in separate lawsuits, influential trade group Pharmaceutical Research and Manufacturers of America (PhRMA)—plus two other organizations—have stepped up to the plate with their own case. PhRMA, along with the Global Colon Cancer Association and the National Infusion Center Association, claim that ...
The National Labor Relations Board (NLRB) returned Tuesday to an Obama-era standard for determining independent-contractor status — effectively broadening the number of people who have a protected right to unionize under the National Labor Relations Act.
Yet another bill that aims to reform the pharmacy benefit management industry has been introduced in Congress, this time by the Senate Finance Committee. The Patients Before Middlemen Act would prevent PBMs that contract with Medicare Part D plans from tying service fees to the price of a drug, rebates, discounts or other fees. PBMs would also ...