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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.

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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Health Provisions in House’s $3.5 Trillion Domestic Policy Proposal

House Democrats are devising a $3.5 trillion domestic policy package that includes billions of dollars in hospital infrastructure, health manpower, nursing shortages and increased insurance coverage. The House Energy and Commerce Committees, and Method and Means Committees that share jurisdiction over health spending and programs, passed their bill provisions this week in line with party ...

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Hospital Groups Push Back Against Stiffer Penalties For Failing To Publish Prices

Hospital industry groups are pushing back against a proposal to jack up fines for health systems that don’t publish their prices, arguing that facilities are putting all their resources behind combating the COVID-19 pandemic. The groups wrote in comments to the 2022 Hospital Outpatient Prospective Payment System (OPPS) rule strongly opposing a proposal to apply ...

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Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage

Despite a pandemic-fueled recession, the number of uninsured Americans has increased only slightly since 2018, according to Census Bureau health insurance data released Tuesday. Twenty-eight million people, or 8.6% of Americans, were uninsured for all of 2020. In 2019, 8% of people were uninsured during the full year; in 2018, it was 8.5%. During a press conference, ...

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CMS Suspends Part D Enrollment In 2022 For UnitedHealth, Anthem MA Plans

The Biden administration has suspended Medicare Advantage Part D new customer enrollment for three United Healthcare Group plans and one Anthem plan for failing to meet medical loss ratio requirements. The Centers for Medicare & Medicaid Services (CMS) announced the suspensions in a series of enforcement notices Sept. 2. The plans are prohibited from signing ...

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