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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.

US Will Make Large Firms Give Paid Time Off for Vaccinations

Companies with at least 100 workers will be required to give employees paid time off to get vaccinated against COVID-19 and paid sick leave if they have side effects from the shots.

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UnitedHealth Lawsuit Claims TeamHealth Upcoded Claims For $100M In Fraud

UnitedHealthcare has filed suit against physician staffing firm TeamHealth, alleging the company upcoded for services to the tune of $100 million. The suit, filed Wednesday in Tennessee federal district court, claims the company purposefully upcoded for tens, if not hundreds, of thousands of medical claims. As one of the largest emergency department staffing companies in ...

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Large Employer Group Launches New Pharmacy Benefit Management Business

A nonprofit coalition of nearly 40 private employers, including U.S. retailers Walmart and Costco, said on Monday it has launched a new company that would offer pharmacy benefit management (PBM) services for employers. With the Covid-19 pandemic weighing severely on people’s emotional and physical wellbeing, companies have been looking to broaden their offerings to support their employees. EmsanaRx, ...

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White House Drops Bid To Add Dental, Vision Benefits To Traditional Medicare In Pared Down Infrastructure Bill

The White House released an updated framework for its trillion-dollar infrastructure package that closes the Medicaid coverage gap and extends enhanced subsidies on the Affordable Care Act’s exchanges. But it drops expanding dental and vision benefits after centrists called for paring down the overall cost of the package, which originally was proposed for $3.5 trillion. ...

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Cigna Expands Access To Virtual Care Services Available Through MDLive

Cigna is expanding access to virtual care through its MDLive subsidiary, including the launch of a new virtual-first health plan pilot for select employers. The insurer said the new programs are an early result of its acquisition of the telehealth company, which closed in April. MDLive is a part of Cigna’s health services arm, Evernorth. Beginning ...

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Medicare Punishes 2,499 Hospitals for High Readmissions

The federal government’s effort to penalize hospitals for excessive patient readmissions is ending its first decade with Medicare cutting payments to nearly half the nation’s hospitals.

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Biden Doubts Medicare Benefits Expansion Could Make It Into Infrastructure Package

President Joe Biden expressed major doubts that adding new benefits to Medicare will make it in a more than trillion-dollar infrastructure package being negotiated in Congress.

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Inside Amazon’s Worst Human Resources Problem

A year ago, Tara Jones, an Amazon warehouse worker in Oklahoma, cradled her newborn, glanced over her pay stub on her phone and noticed that she had been underpaid by a significant chunk: $90 out of $540.

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Business Groups Ask White House To Delay Biden COVID Vaccine Mandate Until After The Holidays

Worried that President Joe Biden’s Covid vaccine mandate for private companies could cause a mass exodus of employees, business groups are pleading with the White House to delay the rule until after the holiday season.

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Direct Primary Care, With a Touch of Robin Hood

Britta Foster and Minerva Tiznado are in different leagues as far as health care is concerned. Foster, who married into the family that owns the $2.5 billion Foster Farms chicken company, has Blue Shield coverage as well as a high-octane primary care plan that gives her 24/7 digital access to her doctor for a $5,900 annual fee ...

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