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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.

Telehealth Use Falls 37% From Pandemic Highs, While Demand For Healthcare Services Projected To Flatten: Report

Future demand for healthcare services will be relatively flat to declining, with little to no effect from the COVID-19 pandemic, according to a new forecast report.

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Employers Fear Costs as States Adopt Public Option Health Plans

Businesses are worried that public option health plans taking shape in some states may end up costing them more than the high premiums they already pay.

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No Surprises Act Regs Leave Out Broker Comp Disclosure Regs

Federal agencies have rolled out 411 pages of No Surprises Act regulations — without giving health insurance agents and brokers anything but one small hint about how they’ll implement the producer compensation disclosure section.

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Surprise Billing Law May Create New Tension Between Providers And Patients

At least one major source of tension remains unresolved regarding the new law banning surprise medical bills: what it looks like for patients to willingly waive their protections — or refuse to waive them. Why it matters: This could yet again pit providers’ rights against their patients’. Driving the news: The Biden administration last week released the first ...

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COVID-19 Continues To Impact Premium Rates

As the health insurance rate-setting season approaches, the big question on everyone’s mind is, “how will COVID-19 impact health premium rates in 2022?” While the full financial impact of COVID-19 is not yet known, it is expected that the ramifications of the pandemic will be experienced for years to come. Based on this, there are ...

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Hospital Prices Must Now Be Transparent. For Many Consumers, They’re Still Anyone’s Guess.

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use. Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. It requires ...

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Trump-Era Law On Surprise Medical Bills Advances Under Biden

The Biden administration on Thursday began putting in place consumer protections against “surprise” medical bills enacted in bipartisan legislation signed last year by former President Donald Trump. Regulations jointly issued by four federal agencies spell out protections for insured patients against surprise billing in medical emergencies, and unexpected charges from out-of-network doctors at an in-network ...

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Employers Not Required to Provide Holiday Pay for Federal Holidays

When President Joe Biden signed the Juneteenth National Independence Day Act on June 17, 2021, creating the Juneteenth National Independence Day to be celebrated on June 19 every year, it created the 11th federal holiday and the first since the creation of the Martin Luther King, Jr. federal holiday in 1983. Juneteenth marks the day ...

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Employers Recognize Mental Health Issues But Face Challenges In Implementing Solutions

The pandemic has heightened awareness of worker mental health issues, especially burnout and isolation. However, many employers struggle to build a fully integrated approach, with low program participation and limited resources cited as the top barriers to success. “The COVID-19 crisis accelerated the evolution of workplace well-being efforts,” said Rebecca Ray, Ph.D., executive vice president, ...

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Biden Administration Aims To Further Rebuild ACA With Proposed Rule

It would lengthen the annual open enrollment period, expand the role of navigators and nix Trump-era guidelines for waivers that were criticized for allowing states to skirt coverage requirements.

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