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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.

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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2022 Proposed Health Insurance Rates Released Prior To Open Enrollment

Nevada consumers shopping for health insurance compliant with the Affordable Care Act can get their first look at the proposed rate changes for 2022 and give the state some feedback.

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Yes, Employers Can Require Workers Get Vaccinated — And It Might Help Them Attract Top Talent

COVID adults have received at least one dose of the vaccine — leaving roughly a third of the population unvaccinated.

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The Word & Brown Companies Again Achieve HITRUST CSF® Certification to Further Mitigate Risk in Third-Party Privacy, Security, and Compliance

The Word & Brown Companies (Word & Brown Insurance Administrators, Inc. and CHOICE Administrators Insurance Services, Inc.) today announced that it has again earned Certified status for information security by HITRUST. Word & Brown and CHOICE Administrators first earned HITRUST CSF Certification in 2018. HITRUST CSF Certified™ status demonstrates that certain systems used by Word ...

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Study: Drug Utilization Costs Health Industry $93B A Year, With Patients Bearing Most Of The Cost

Drug utilization management such as prior authorization and stricter formularies cost the healthcare industry $93 billion annually, with patients bearing the largest share of the cost, a new study found. The study, published Monday in the journal Health Affairs, found that intense use of drug utilization measures has led to patients spending $35.8 billion a year in ...

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