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.
Pharmacies that carved out new lines of business during the pandemic are pushing to expand their reach amid a broader effort to rethink the health care consumer experience. Why it matters: Pharmacies got paid to deliver vaccines, tests, and treatments for COVID during the pandemic. The experience primed consumers to expect the kind of on-demand health access ...
The arguments that hospitals’ trade groups have used for years — mainly, that they need more money from the government — are beginning to fall flat, indicating one of Washington’s most powerful lobbying juggernauts may be losing some goodwill. While groups like the American Hospital Association, which represents about 5,000 hospitals and which spent $27 ...
Policy analysts, Democrats, and Republicans dissatisfied with the deal agree: Federal health programs have dodged a budgetary bullet in the Washington showdown over raising the nation’s debt ceiling.
A federal appeals court will hear arguments Tuesday about whether to continue a pause of a Texas district court’s ruling that struck down an ObamaCare provision requiring insurers to cover preventive services for free.
The cracks in Medicaid that some experts feared eligible beneficiaries could slip through during the disenrollment process appear to forming, according to a new KFF survey. Many people eligible for Medicaid have not gone through the reenrollment process before. Many others simply aren’t aware that they’re eligible, according to KFF’s review of early data from 11 states. These ...
Biosimilars were supposed to be the catalyst for lower biologics prices, but in the case of insulin products, the leadership now seems to be coming from Medicare and the three dominant insulin producers: Eli Lilly, Novo Nordisk and Sanofi. Following a provision in the Inflation Reduction Act of 2022 that limited the monthly out-of-pocket cost ...
The U.S. Medicare health plan said on Thursday it would limit reimbursement for Eisai Co Ltd (4523.T) and Biogen Inc’s (BIIB.O) Alzheimer’s drug Leqembi to patients whose doctors participate in a health agency database should the drug win full approval, a move advocates say will hinder its use. The decision marks the first time that Medicare has required data-collection ...
There are concerns about the deal to raise the debt ceiling struck over Memorial Day weekend. One hang-up some conservatives have is the insufficient amount of provisions stipulating that individuals must engage in employment, job training, or community service to qualify for certain government-assistance programs.
Democratic lawmakers say they agreed to fine Californians without health insurance on the condition the state use that money to lower costs for residents purchasing coverage on the state exchange. They say Gov. Gavin Newsom has reneged on the deal.
The bill would require PBMs to meet new transparency requirements and would ban spread pricing in Medicaid. The (PATIENT) Act mandates that PBMs compile annual reports for employers with a slew of key information, including their drug spending, out-of-pocket costs, rebates, formulary placement and acquisition costs.