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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.

California Senate Passes PBM Control Bill That A Big Employer Group Hates

The California Chamber of Commerce says weakening pharmacy networks will drive up employers' drug benefits costs.

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Republicans Face New Pressure To Extend Expiring Obamacare Tax Credits

If the money lapses this year, 5 million are expected to lose coverage and others would face premium hikes in 2026. A new coalition is pushing reluctant GOP lawmakers to extend it.

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Republicans Are Trying To Repeal Obamacare Again. Sort Of.

Congressional Republicans are pursuing changes to the Affordable Care Act that would mean 10.7 million fewer Americans using its insurance marketplaces and Medicaid, a huge reduction that some view as a way to accomplish part of the health-care coverage cancellation that failed in 2017. They’re not branding it a repeal of President Barack Obama’s signature ...

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The House Just Passed ‘One Big Beautiful Bill.’ Here Are The Healthcare Issues In It.

The House early Thursday narrowly passed the One Big Beautiful Bill Act, a budget bill that includes several healthcare provisions that could significantly impact Medicaid, Medicare, and the Affordable Care Act (ACA).

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CMS Updates Hospital Price Transparency Guidance Following Executive Order

CMS updated its hospital price transparency guidance May 22, requiring hospitals to post the actual prices of items and services, not estimates. The update comes after President Donald Trump issued an executive order Feb. 25 aimed at boosting healthcare price transparency. In the updated guidance, CMS said hospitals must display payer-specific standard charges as dollar amounts in their machine-readable ...

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Trump Signs Executive Order Setting 30-Day Deadline For Drugmakers To Lower Prescription Drug Costs

President Donald Trump on Monday signed a sweeping executive order setting a 30-day deadline for drugmakers to electively lower the cost of prescription drugs in the U.S. or face new limits down the road over what the government will pay.

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P4ESC Warns Congress Not to Tax Health Benefits

“We oppose taxing health benefits,” said Neil Trautwein, P4ESC’s Executive Director. “Policymakers will find how widely unpopular the idea will be with Americans with this type of coverage if they take this unwise step,” added Trautwein.

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Pharmacist Group Tells Elon Musk’s Team To Probe Pharmacy Benefit Managers

The National Community Pharmacists Association wants Elon Musk’s Department of Government Efficiency to help it fight the pharmacy benefit managers. The pharmacist group announced Friday that it had sent a letter encouraging DOGE to search for waste, fraud and abuse at PBMs. The PBMs contend that they fight to hold down prescription drug costs for employer health plan ...

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Supreme Court’s Bold Move To Save Part Of ACA Preventive Services Package

The U.S. Supreme Court implied Friday that the outcome of a big Affordable Care Act preventive services benefits case may depend on legal issues that are unrelated to health insurance.

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How The State Sent Californians’ Personal Health Data To LinkedIn

The state’s health insurance exchange transmitted pregnancy and domestic abuse data during a marketing campaign. It is reviewing its website practices.

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