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.
Nine out of 10 Medicare Advantage members are enrolled in plans that earned the government's highest quality marks for 2022, according to new federal data.
Due largely to concerns about the COVID-19 pandemic and its continued effects on American healthcare, employers are expecting their health costs to rise more than 5% in 2022, according to a new Willis Towers Watson survey.
Teladoc Health is taking its primary care pilot nationwide, expanding it to commercial health plans, employers and other payers. The telehealth giant piloted its virtual primary care program, called Primary360, in 2019 with the aim of early detection of chronic disease. The service now offers 70 distinct diagnoses such as hypertension and diabetes, Teladoc CEO Jason ...
For a brief moment this summer, it seemed like small businesses might be getting a break from the relentless onslaught of the pandemic. More Americans, many of them vaccinated, flocked to restaurants and stores without needing to mask up or socially distance. But then came a surge in cases due to the delta variant, a ...
Private insurers sometimes negotiate rates on hospital services that are higher than the cash price, a recent New York Times investigation found, and the same basic service can cost widely varying amounts even at the same hospital. The Times surveyed 60 major hospitals that are complying with this year’s new Centers for Medicare & Medicaid Services (CMS) rule ...
Donna Weiner looks at Medicare’s prescription drug program from two different points of view. As a participant, she wants to pay less for her medicines, which cost her about $6,000 a year. As a retired accountant who spent 50 years handling the books for companies, she sees a way to get there. “You know from working in ...
As Congress debates cutting prescription drug costs, a poll released Tuesday found the vast majority of adults — regardless of their political party or age — support letting the federal government negotiate drug prices for Medicare beneficiaries and those in private health insurance plans. The argument that pharmaceutical companies need to charge high prices to ...
Eighteen former NBA players were charged Thursday with pocketing about $2.5 million illegally by defrauding the league’s health and welfare benefit plan in a scam that authorities said involved claiming fictitious medical and dental expenses. “The defendants’ playbook involved fraud and deception,” U.S. Attorney Audrey Strauss told a news conference after FBI agents across the ...
Leadership may drop efforts to have the government directly negotiate the prices for medicines in private insurance plans and make fewer drugs subject to negotiations in Medicare, among the changes under consideration.
As the use of telehealth has become more widespread, consumer satisfaction has fallen, according to a recent survey.