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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’s Progressive — and Expensive — Health Care Ambitions Rely on Biden Win

For deep blue California, where first-in-the-nation health care proposals regularly flood the Democratic agenda, there could not be more at stake in the presidential race.

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Pelosi Eyes Reconciliation To Boost Obamacare, Pandemic Aid

House Speaker Nancy Pelosi on Monday said Democrats will deploy budget reconciliation procedures next year to enhance the Affordable Care Act and provide additional pandemic relief if the party secures a narrow majority in the Senate, wins the White House and maintains control of the House.

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CMS Finalizes Price Transparency Rule Aimed At Health Plans

The Transparency in Coverage rule will require health insurers and self-insured health plans to share details on pricing and cost-sharing.

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Hospital Bills for Uninsured COVID Patients Are Covered, but No One Tells Them

When Darius Settles died from COVID-19 on the Fourth of July, his family and the city of Nashville, Tennessee, were shocked. Even the mayor noted the passing of a 30-year-old without any underlying conditions — one of the city’s youngest fatalities at that point.

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Medicare Fines Half of Hospitals for Readmitting Too Many Patients

Nearly half the nation’s hospitals, many of which are still wrestling with the financial fallout of the unexpected coronavirus, will get lower payments for all Medicare patients because of their history of readmitting patients, federal records show.

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Insurers Slam CMS Proposal To Hasten Medicare Coverage Of Breakthrough Medical Devices

A major insurance group blasted a proposed rule intended to grant faster Medicare coverage decisions on new breakthrough medical devices, saying the rule could lead to unsafe devices reaching seniors.

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HHS Prioritizing Health Data Access Through Smartphones In 5-Year Strategic Plan

Federal health IT officials outlined their top goals and priorities for the next five years with a big focus on pushing the industry to make more patients' health data accessible through smartphone apps.

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ACA: Obamacare Under Siege Again As Nevada Health Insurance Exchange Enrollment Starts

After its troubled launch in 2013, Nevada’s health insurance exchange is kicking off its latest enrollment period on Nov. 1 with some long-sought stability and none of the drama that plagued the program in previous years.

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High Deductibles Not Sufficient To Change Employee Behavior: EBRI

High-deductible health plans might help make members more selective early in their plan year, but once they meet that deductible, all bets are off. A report from the Employee Benefit Research Institute shows that the likelihood of using low-value health services increases by as much as 83% once plan members meet their deductible. That includes services like cancer screenings below recommended ages, imaging for uncomplicated headaches, and vitamin D or prostate-specific antigen tests.

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CVS To Add 1K Rapid-Result COVID-19 Test Sites At Pharmacies

CVS Health is adding 1,000 more rapid-result testing sites at its pharmacies by the end of the year.

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