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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.

Dentists’ Organization Fights Plan To Cover Dental Benefits Under Medicare Expansion

The American Dental Association is mobilizing its 162,000 members to fight a proposal to include dental coverage for all Medicare recipients, opposition that could prove pivotal as Democrats look to make cuts in their $3.5 trillion domestic policy agenda. Giving dental, vision and hearing benefits to the 60 million older and disabled Americans covered by Medicare will provide ...

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KFF: Analysis Finds Out-Of-Pocket Spending On Dental, Hearing In Medicare Far Outweighs Vision Benefits

Out-of-pocket spending for hearing and dental care far outpaced spending for vision care among Medicare beneficiaries, a new analysis found. The analysis, released Tuesday by the Kaiser Family Foundation, examines out-of-pocket spending in 2018 and 2019 on traditional Medicare and Medicare Advantage on the three benefits. It comes as Congress is contemplating adding the three benefits ...

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Hospital Finances ‘Not Out Of The Woods Yet’ As Delta Fuels High-Acuity Stays In August

Hospitals’ August financials bowed under the weight of the COVID-19 delta variant, albeit not nearly to the extent they did during the widespread disruption of 2020, per Kaufman Hall. According to the group’s latest monthly report on industrywide performance, upticks in new COVID-19 cases and hospital admissions maintained pressure on hospitals’ bottom lines. By most ...

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UnitedHealth Group Develops Calculator That Allows Schools, Businesses To Simulate COVID Testing Programs

As schools and businesses weigh their options for tracking COVID-19 cases, UnitedHealth Group’s researchers have developed an online calculator tool these organizations can use to game out potential testing programs. The free tool allows users to simulate the financial cost as well as the likely number of false positives for several different testing options and frequencies. For ...

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UnitedHealthcare To Make Apple Fitness+ Available In Fully Insured Employer Plans

UnitedHealthcare is making Apple Fitness+ available to millions of members at no cost, the insurer announced Thursday. Beginning Nov. 1, members in fully insured plans who already own an Apple Watch will be able to sign up for a yearlong Apple Fitness+ subscription for free. This covers about 3 million members across most states, UnitedHealthcare said. Self-funded ...

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Payers Double Down On Population Health Programs Amid COVID-19

Among the many initiatives accelerated by the COVID-19 pandemic are efforts to combat inequities in the U.S. healthcare system that have persisted for years but were brought into stark relief when the coronavirus reached the country’s shores. As a result, payers are implementing new programs to try and improve member health beyond the traditional care ...

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Mercer: 3 Ways Employers Can Continue To Enhance Benefits Options

Employer health supports have a meaningful impact on workers' resilience and well-being, according to a new survey from Mercer. The survey found that the pandemic did significant damage to the mental, physical and financial health of workers.

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Moderate Democrats Sink Pelosi’s Aggressive Drug Pricing Bill In Key Committee Vote

House Speaker Nancy Pelosi’s aggressive drug pricing package failed a key committee vote on Wednesday, prompting questions about whether the measure can survive a full House vote.

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Is Digital Health The Key To Making The Industry More Efficient?

As healthcare continues its digital transformation, questions arise about what role technology such as remote patient monitoring and virtual healthcare platforms will actually play in a post-pandemic. “In a sense, COVID has provided an opportunity for healthcare stakeholders to improve and try to focus on leveraging these innovations to better manage healthcare services,” said Jailandra ...

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15 Million People Could Lose Coverage After Public Health Emergency Ends, Report Says

A new report by the Urban Institute, funded by Robert Wood Johnson Foundation, anticipates that 15 million people could be out of Medicaid coverage when the pandemic public health emergency ends. Medicaid enrollment initially swelled as a result of early pandemic joblessness and continuous coverage requirement of the Families First Coronavirus Response Act, according to ...

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