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.
Some of the world’s biggest drugmakers are laying legal groundwork to fight the U.S. plan to negotiate drug prices for its Medicare health coverage, including the argument that a ban against speaking about these talks violates constitutional rights, according to six industry sources. The Biden Administration’s signature drug pricing reform, part of the Inflation Reduction ...
As the expiration of the Covid-19 public health emergency declaration approaches, the US Drug Enforcement Administration has extended the flexibilities regarding the prescription of controlled medications via telehealth. Before the pandemic, medical practitioners were subject to the conditions of the Ryan Haight Act, which required at least one in-person medical examination before prescribing a controlled medicine, ...
Spring heralds the start of rate review season: that time of year when state departments of insurance assess health insurers’ proposed rates for the next year and determine whether their plans comply with federal and state laws. Many state insurance departments now have a new responsibility as part of that process
The Drug Enforcement Administration has asked the White House for more time to finalize draft rules that proposed reinstating stricter limits requiring doctors to evaluate patients in-person before prescribing certain drugs — like Adderall and opioid use disorder treatment — via telehealth. Driving the news: DEA administrator Anne Milgram said on Wednesday that temporarily keeping the pandemic-era flexibilities in place would allow ...
Medical experts urged Congress to hold insurance companies accountable for inaccurate medical directories that can hamper access for patients seeking mental health treatments. The problem, referred to as a “ghost network,” occurs when health insurance providers ostensibly provide coverage, but direct customers to nonexistent or unavailable doctors and providers. “In my view, it’s a breach ...
A new KFF analysis finds that an estimated 1.7 million Medicaid enrollees could become ineligible for federal Medicaid under proposed work requirements and presents state-by-state projections, based on estimates of coverage loss from the Congressional Budget Office (CBO). States could continue to provide Medicaid to those enrollees but would not receive federal matching funds for doing so. ...
Some employers have already followed the advice in a ruling by a federal district court judge in Texas that struck down mandates for no-cost preventive care in the Affordable Care Act and have stopped paying for certain services. The National Alliance of Healthcare Purchaser Coalitions polled 30 employers who cover 1.5 million workers, and found 72% of ...
House lawmakers are kick-starting the legislative process for a number of health care bills at the same time their Senate counterparts are shaping their own package on drug pricing, and members appear to be finding common ground on pharmacy benefit managers.
The Centers for Medicare & Medicaid Services (CMS) today unveiled two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM), that together would further strengthen access to and quality of care across Medicaid and the Children’s Health Insurance Program (CHIP), the nation’s largest health coverage programs. ...
Despite cybersecurity experts’ repeated warnings, the insurance sector, along with other industries, is not doing a great job when it comes to creating secure passwords, says new research by password manager NordPass. Though employees are repeatedly warned to take better care of corporate accounts, passwords such as “password” and “123456” still score high on the ...