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.
Cash prices for certain hospital services were lower than the average insurance rate in nearly half of the facilities examined in a new study, which could influence rate negotiations between payers and providers.
On March 30, a single federal judge in Texas struck down a provision of the Affordable Care Act (ACA) that required free coverage for a host of preventive health services for people with private insurance. Under this decision, private health plans are no longer required to cover certain cancer screenings, services or medications to prevent heart disease, or perinatal depression preventive interventions, among others, with no cost sharing.
Since the COVID-19 pandemic began in earnest, low-income Californians who enrolled in Medi-Cal — California’s version of the government-funded Medicaid health insurance program — have been able to keep their coverage without having to prove every year that they still qualified for it. That’s because the Families First Coronavirus Response Act, which President Trump signed ...
President Joe Biden signed legislation Monday to end the national emergency for Covid-19, the White House said, in a move that will not affect the end of the separate public health emergency scheduled for May 11. A White House official downplayed the impact of the bill, saying the termination of the emergency “does not impact our ...
“California has taken action proactively to enact strong consumer protections into state law, including requirements on health plans to cover preventive care with no cost sharing to enrollees.
A federal judge in Texas who previously ruled to dismantle the Affordable Care Act struck down a narrower but key part of the nation's health law Thursday in a decision that opponents say could jeopardize preventive screenings for millions of Americans.
On February 21, 2023, the IRS released Final Rules amending the existing requirements related to mandatory e-filing of information returns, including Forms 1094-C and 1095-C, among others. The final rules are effective for all applicable returns due on or after January 1, 2024.
A key Senate committee advanced legislation to ban pharmacy benefit manager tactics, such as spread pricing and clawback fees, and heighten transparency of the industry. The Senate Commerce Committee passed the PBM Transparency Act of 2023 by a vote of 18 to 9 on Wednesday, advancing the reform legislation to the full Senate. Lawmakers said the legislation ...
The arbitration process in the No Surprises Act, which was enacted to make the health care system more transparent, has become “a big mess,” a U.S. senator said last Wednesday at a Senate Finance Committee hearing.
The IRS has announced the 2024 employer mandate penalties under the Affordable Care Act for employers with 50 or more full-time equivalent employees. Under the ACA, employers may be subject to an employer mandate penalty for (1) failing to offer minimum essential coverage to 95% of full-time employees (A Penalty) or (2) offering coverage that is not affordable (B Penalty).