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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.

Doctor on Call? Lawmakers Debate How Much to Pay for Phone Appointments

It took covid-19 to give millions of Americans the option of telling their doctor about their aches and pains by phone. But now that more doctors and patients are returning to in-person appointments, policymakers across the country are divided over how much taxpayer money to keep spending on phone appointments. Although they were a lifeline ...

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Most Hospitals Aren’t Complying With Price Transparency Rule

Most hospitals aren’t fully complying with a new federal rule requiring them to make their prices available, according to a new study in JAMA Internal Medicine. Why it matters: The goal of the regulation is to allow price shopping and, thus lower costs, although it’s unclear whether it’d have this effect. The big picture: Hospital prices can vary ...

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To Curb Drug Prices, Democrats Still Seeking A Balance

Democrats are committed to passing legislation this year to curb prescription drug prices, but they’re still disagreeing on how to cut costs for patients and taxpayers while preserving profits that lure investors to back potentially promising treatments. It boils down to finding a balance: How big a stick should Medicare have to negotiate prices with ...

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HHS Warns Providers, Insurers COVID-19 Testing Must Be Free For Patients

Dive Brief: * HHS Secretary Xavier Becerra on Wednesday sent a letter to healthcare providers and insurers reminding them that COVID-19 vaccines and testing must be free without charge for patients. * The agency said Becerra issued the warning following recent reports of Americans facing costs associated with coronavirus vaccinations and tests. Becerra’s letter forcefully states that group health plans and health insurers ...

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Industry Awaits Supreme Court Decision On ACA Case

Once again, the healthcare industry will be closely watching the Supreme Court on Thursday to see whether the high court delivers an opinion in the controversial case that could overturn the Affordable Care Act, throwing coverage for millions into question.

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Becerra Pledges To Offer Providers Guidance And Flexibility On June 30 COVID-19 Relief Fund Deadline

Department of Health and Human Services (HHS) Secretary Xavier Becerra said guidance is coming to help providers meet a June 30 deadline to spend all their COVID-19 relief funds but didn’t endorse an extension that several groups have called for.

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Biden Administration Will Limit Mandatory COVID Workplace Safety Rules To Health Care Settings

The Labor Department will limit long-awaited emergency Covid-19 workplace safety rules to the health care sector, Labor Secretary Marty Walsh said Wednesday, a decision that disappointed unions pushing for more expansive rules but that will likely be a relief to businesses worried about new costs.

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Amazon, Walmart Duke It Out For Consumers’ Prescription Business

Both Amazon and Walmart announced plans this week to offer discounted prescriptions to consumers — effectively encouraging them to forego their existing health insurance benefits. As Bloomberg.com reports, Amazon now offers six-month prescriptions starting at $6 for medications that treat common ailments. Because most insurance companies don’t cover six-month prescriptions, the move is considered a way to ...

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Medical Cost Trends To Increase In 2021, Drop In 2022

A new analysis predicts that medical cost increases will moderate slightly in the U.S. in 2022, following a higher rate of increase in 2021 as the health system deals with the aftermath of the COVID-19 pandemic. The analysis, by the PwC Health Research Institute (HRI), is the latest installment of the Institute’s annual cost trend ...

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Can a Subscription Model Fix Primary Care in the US?

In April, San Francisco-based primary care company One Medical revealed an eye-popping compensation package for its chief executive and chairman, Amir Dan Rubin. His $199 million payday, particularly noteworthy at a company that has yet to turn a profit, made Rubin the second-highest-paid CEO in the United States last year — but only on paper. About $197.5 million of ...

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