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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.

Cost Still The Main Hurdle For Small Business Employers Looking To Expand Benefits

Small business owners understand the value of offering benefits, but some struggle to afford them, and businesses can pay a high price tag for making mistakes in administration of benefits, a new report finds.

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Telehealth’s Limits: Battle Over State Lines and Licensing Threatens Patients’ Options

If you live in one state, does it matter that the doctor treating you online is in another? Surprisingly, the answer is yes, and the ability to conduct certain virtual appointments may be nearing an end.

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Actuaries Project Future Virus Surges, End Of Regulatory Flexibility Key Drivers In 2022 Rates

Uncertainty over future surges of COVID-19 and the end of regulatory flexibilities are going to be major drivers for 2022 premiums on the individual and small group markets, a new actuary report finds. The report, released Thursday (PDF) by the American Academy of Actuaries, finds insurers face major uncertainties like the end of the public health emergency ...

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Medicare Trustees Project Hospital Fund To Run Out In 2026, Same Deadline As Year Before

Medicare’s insurance trust fund that pays hospitals is expected to run out of money in 2026, the same projection as last year, according to a new report from Medicare’s board of trustees. The report, released Tuesday, found Medicare spent $925.8 billion in 2020 and served 62.6 million people. It found that the COVID-19 pandemic had a ...

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Pfizer COVID Booster Shots Will Likely Be Ready Sept. 20, But Moderna May Be Delayed, Fauci Says

The U.S. will likely start to widely distribute Pfizer Covid-19 booster shots during the week of Sept. 20, but the rollout for Moderna’s vaccine could be delayed, White House chief medical advisor Dr. Anthony Fauci said Sunday. The Biden administration has announced plans to offer third doses to people who received the Pfizer and Moderna shots, pending approval ...

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Centene To Consolidate Its Medicare Advantage Plan Branding Under Wellcare

Centene is consolidating all of its Medicare Advantage (MA) brands under the Wellcare name, the government insurance giant announced Thursday. Centene closed its acquisition of Wellcare Health Plans in January 2020, which led to a slew of disparate MA brands across 33 states, the company said. The $17 billion deal created one of country’s largest sponsors of government insurance. ...

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COVID Medical Bills Are About to Get Bigger

Americans will most likely pay significantly more for COVID medical care during this new wave of cases — whether that is a routine coronavirus test or a lengthy hospitalization.

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Special COBRA Notice Deadline For Employers Approaching Fast

The deadline to send a new COBRA notice required under the American Rescue Plan Act of 2021 (ARPA) is approaching quickly. Employers and COBRA administrators will need to send those notices no later than September 15, 2021, to satisfy that obligation. Under ARPA, certain COBRA qualified beneficiaries are entitled to subsidized COBRA coverage through September ...

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Survey: Quarter Of Couples Who Married In 2020 Did So For Health Insurance

Of the estimated 1.3 million couples who were married in the U.S. in 2020, 26% said they did so because either they or their partner needed health insurance, according to a new survey from AffordableHealthInsurance.com.

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Business Groups Withdraw Suit Challenging Health-Price Transparency Rule

The U.S. Chamber of Commerce and a Texas affiliate withdrew a suit filed to block parts of a federal rule requiring insurers and employers to disclose prices they pay for healthcare services and drugs.

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