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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.

Supreme Court Sets Jan. 7 Special Hearing On Vaccine Mandate For Healthcare Workers

The Supreme Court is fast-tracking two legal cases challenging President Joe Biden’s COVID-19 vaccine mandates, including a requirement for certain healthcare workers. The high court announced Wednesday it will hold a special hearing Jan. 7 to hear oral arguments over federal vaccine mandates that are at the heart of the Biden administration’s efforts to address COVID in ...

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HHS Appeals Judge’s Ruling That Drugmakers Can Cut Off 340B Sales To Contract Pharmacies

The Biden administration is appealing a federal ruling that said drugmakers have the authority to restrict sales of 340B-discounted products to contract pharmacies. The Department of Justice filed an appeal Tuesday to a lawsuit brought by Novartis and United Therapeutics over drugmakers’ ability to cut off sales to contract pharmacies. It also appealed several aspects of other ...

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Medicare Advantage Market Shows Signs Of Valuation Bubble Ready To Burst

The past several years have seen headline after headline about investors buying up Medicare Advantage-focused providers for huge sums of money and throwing cash behind startup insurers that promise to disrupt the $350 billion market. Meanwhile, there’s been an eye-popping number of new ventures seeking to capture a corner of the growing patient population. This ...

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New Year Brings 55 New Laws To Nevada

A total of 55 new laws will take effect Jan. 1, including the next step in Nevada’s attempt to create a Medicaid-like public health insurance option for all residents.

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Biden Bolsters COVID-19 Effort As Highly Contagious Omicron Variant Spreads Fast And WHO Urges People To Cancel Christmas Parties

As the omicron variant of the coronavirus that causes COVID-19 continues to spread across the country, U.S. President Joe Biden is planning to announce 500 million free rapid tests for Americans, along with federal help for stressed hospitals, and a renewed push for vaccinations and booster shots.

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CMS: Insurers Paid Out $2B In Medical Loss Ratio Rebates For 2020 Claims

Insurers gave out approximately $2 billion in rebates for 2020 to nearly 10 million consumers under the Affordable Care Act’s (ACA’s) medical loss ratio provision. The Centers for Medicare & Medicaid Services (CMS) released Friday a list of insurers that sent out payments for the past year. The ACA requires insurers to spend a certain ...

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Criminals Have Stolen Nearly $100 Billion In COVID Relief Funds, Secret Service Says

Criminals have stolen close to $100 billion in pandemic relief funds, the U.S. Secret Service said Tuesday. The stolen funds were diverted by fraudsters from the Small Business Administration’s Paycheck Protection Program, the Economic Injury Disaster Loan program and a another program set up to dole out unemployment assistance funds nationwide. More than $2.3 billion ...

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Amazon Taps Former Prime Executive To Oversee Virtual Care, Pharmacy And Diagnostics Businesses

Amazon has consolidated its healthcare efforts under one central organization and tapped a former Prime executive to run the businesses. The tech giant elevated Neil Lindsay to the new role of senior vice president of health and brand within Amazon’s worldwide consumer business, an Amazon spokesperson confirmed to Fierce Healthcare. CNBC’s Annie Palmer and Bertha ...

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‘It Is Embarrassing’: CDC Struggles To Track COVID Cases As Omicron Looms

As the world experiences new, more transmissible Covid-19 variants, scientists and health officials in the U.S. are still struggling to gather accurate and timely domestic data to help inform policy decisions to safeguard Americans. Continuing gaps in the CDC’s data collection program, which almost two years into the pandemic still relies on state health departments ...

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U.S. Could See 1 Million Cases Per Day, Warns Departing NIH Director Francis Collins

After spending more than 12 years as director of the National Institutes of Health, Dr. Francis Collins is retiring this weekend. But he’s no less worried about the public health agency’s latest pandemic curveball. As the omicron variant threatens record-breaking rates of infections in the U.S., Collins departs with a warning. If Americans don’t take ...

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