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 Biden administration on Monday released updated guidelines for traveling into the United States, including stricter requirements on U.S. citizens who have not been vaccinated against Covid-19 as well as some exceptions for foreign travelers. Beginning Nov. 8, unvaccinated U.S. citizens and long-term residents will have to present a negative Covid test taken a day before re-entering the ...
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 ...
Democrats are haggling over whether to drop two of the most popular elements of their social spending bill as negotiations reach the zero hour, according to a half-dozen sources close to the discussions. While high-level talks on the $1 trillion-plus package are ongoing, lawmakers, staffers, advocates and lobbyists said that a plan to expand Medicare ...
At issue are parameters an arbiter should consider when determining payment a health plan and provider can’t determine on their own
Two new pharmacy benefit management startups are aiming to inject greater price transparency into the market. The Purchaser Business Group on Health has announced Emsana Health, with its first business arm launching as EmsanaRx, a PBM. As PBGH is a coalition of 40 large employers, the company says its PBM solution is “built by employers, ...
Congressional Democrats are watering down — and may entirely drop — a plan to have the government directly negotiate some Medicare drug prices in order to help clinch a deal on their sweeping social spending package. Top Democrats have acknowledged for weeks that they’ve had to significantly weaken the plan in order to win over holdout centrist lawmakers. ...
Through this new health plan, eligible UnitedHealthcare members will be able to receive various types of care, including wellness, routine, chronic condition management, urgent and behavioral health services, wherever they are.
The Affordable Care Act (ACA) requires medical health insurers to offer a one-month Special Open Enrollment Window (SOEW), when eligible Small Group employers can enroll in medical coverage without having to meet standard employer-contribution and/or employee-participation ratios.
Walmart and Transcarent will work together to make it easy for clients and members to access Walmart services and Walmart’s everyday low-cost pricing
This year, the Illinois legislature was considering measures to expand oral health treatment in a state where millions of people live in dental care deserts. But when the Illinois State Dental Society met with key lawmakers virtually for its annual lobbying day in the spring, the proposals to allow dental hygienists to clean the teeth of ...