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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.

Early 2021 Data Show No Rebound In Health Care Utilization

Early in the COVID-19 pandemic, stay-at-home measures, potential risk of COVID infection at a hospital or doctors’ offices, and concerns over hospital capacity led to sharp declines in health care utilization and spending, including drops in hospital admissions for both acute and elective procedures. There was also a drop in preventive service use. Spending decreased across all health services. While telemedicine use increased rapidly during the ...

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Shift To Hybrid Work Model Creates Challenges And Opportunities For HR Professionals

U.S. employees enjoy working remotely, a survey from Glassdoor found. Nearly nine in 10 said they prefer to continue working from home at least part of the time after offices reopen; 23% would consider quitting if they were required to return to the office before all employees have been vaccinated; and 17% would consider quitting ...

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5 Reasons Employers Should Consider Funding Supplemental Health Benefits

A recent study showed that 77% of employees would consider leaving their jobs because of poor benefits. It may seem like a natural solution to add more benefits, but with limited budgets, supplemental plans are often added on a voluntary basis. Employees may not see a plan they have to pay for as a “benefit”— especially if ...

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U.S. To Recommend COVID Vaccine Boosters At 8 Months

U.S. health experts are expected to recommend COVID-19 booster shots for all Americans eight months after they get their second dose of the vaccine, to ensure longer-lasting protection as the delta variant spreads across the country. Federal health officials have been looking at whether extra shots for the vaccinated would be needed as early as ...

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Surge In New COVID-19 Cases Amid Delta Spread ‘Going Very Steeply Upward’

The surge in coronavirus spread in the U.S. is driving case totals to highs last seen six months ago. For much of last week, the Centers for Disease Control and Prevention (CDC) reported daily case numbers upwards of 100,000, with Thursday’s high of nearly 147,000 not previously seen since late January. On Sunday, the U.S. led the world in ...

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Framework For $3.5T Senate Package Seeks To Close Medicaid Gap, Add New Medicare Benefits And Tackle Drug Prices

Senate Democrats want to give Medicare the power to negotiate for lower drug prices, add new benefits to Medicare and close a Medicaid coverage gap in a new $3.5 trillion infrastructure package.

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Biden To Pull The Plug On “Most Favored Nation” Drug Rule

The Biden administration plans to pull the plug on a contentious Trump-era demonstration that would tie Medicare outpatient drug pay to other wealthy countries’ drug prices, according to a CMS proposed rule on Friday. Hospitals had opposed the “most favored nation” drug policy, arguing that it would hurt their bottom lines and put the entire ...

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2020’s Rapid Shift To Working From Home Upped The Cost Of Data Breaches

Operational changes made during the pandemic often carried a steep price. Data breaches now cost companies a record $4.24 million per incident on average, according to a global survey by IBM Security. Businesses were forced to quickly adapt their technological approaches last year, with many companies encouraging or requiring employees to work from home and ...

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Insurers Came Back Down To Earth In Q2 Following Sky-High Profits A Year Ago

UnitedHealth Group was again the most profitable insurer in a quarter filled with companies warning that the pandemic is likely to remain a significant headwind through the end of 2021, especially as the delta variant spreads. UHG brought in $4.3 billion in profit in the second quarter on $71.3 billion in revenue. CVS Health was ...

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Aetna, CVS Health To Enter The Affordable Care Act (ACA) Individual Insurance Exchange Marketplace In Nevada For January 1, 2022

Aetna and CVS Health (NYSE: CVS) will enter the individual insurance exchange market in Nevada (specifically in select counties in the Las Vegas and Reno markets) with their first Aetna CVS Health hybrid-branded insurance product, providing access to health care for more Nevadans.

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