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 ban on surprise medical bills protected patients from more than 10 million claims for out-of-network services in the first nine months of 2023, according to new estimates by health insurer groups. But the process for settling billing disputes is still in disarray. Why it matters: AHIP and the Blue Cross Blue Shield Association said more than 670,000 ...
Rule would require Medicare Advantage organizations, Medicaid and other government-sponsored health programs to include specific reasons for denying requests
The bill’s introduction comes days before Gov. Gavin Newsom would present his plan for closing the state’s $68 billion budget deficit. Newsom has repeatedly cited his commitment to protecting the expansion, which is estimated to cost $4 billion per year.
New Biden administration rule could impose stricter test for Uber, Lyft and others to classify workers as contractors
A “pivotal year for price transparency” closed out with most—but not all—of the healthcare industry publishing their data publicly and at a higher quality, price transparency data startup Turquoise Health wrote in a state-of-the-industry report released Thursday.
Employers that were considered “Applicable Large Employers (ALEs)” in 2023 must file IRS reports by April 1, 2024, detailing their compliance with the ACA’s employer mandate. ALEs must generate a report for each person employed full time for at least one full calendar month of 2023.
The IRS announcements include a number of dollar amounts employers will need to know in order to administer their benefit plans for 2024, including the key dollar amounts for retirement plans, FSAs, HSAs and HDHPs.
Legal experts indicated they will be paying close attention to lawsuits surrounding the Medicare drug price negotiation program and Braidwood v. Becerra. Both topics could have massive ramifications on the healthcare industry and set new precedents.
If any year is looked back on as pivotal in California’s fight to curb mental illness, homelessness and drug-related deaths, 2023 could be the one. Gov. Gavin Newsom pushed major — and at times controversial — reforms of the state’s mental and behavioral health systems through the Legislature, but a mere two months after signing the laws, ...
Three major government agencies are adding new officials to investigate price-gouging in health care — positions experts say will help the three agencies better coordinate across the government.