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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.

China’s Grip On American Medicine Cabinets Grows More Entrenched

A US congressional commission is ringing alarm bells about China's growing dominance over America's drug supply, saying it is putting the country's health in the hands of an adversarial nation.

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Managed Care Plans Offer Recommendations To CMS On Rollout Of Medicaid Work Requirements

Two leading organizations representing Medicaid managed care plans are offering several key suggestions to the Trump administration for managing the rollout of work requirements in the program. In the letter (PDF), experts at Medicaid Health Plans of America (MHPA) and the Association for Community-Affiliated Plans (ACAP) urged the Centers for Medicare & Medicaid Services (CMS) to allow ...

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FDA To Streamline Approvals Of Generic Biologic Drugs

The Food and Drug Administration (FDA) is launching an effort to streamline the approval process for cheaper alternative “biosimilar” versions of biologic drugs as a way to curb health costs. The agency published a draft guidance for industry Wednesday that would potentially make it faster and less costly for companies to develop biologics and bring them to market, leading to increased competition and lower drug costs for patients. The ...

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Trump Administration Moves To Overrule State Laws Protecting Credit Reports From Medical Debt

The Trump administration is moving to overrule any state laws that may protect consumers’ credit reports from medical debt and other debt issues. The Consumer Financial Protection Bureau has drafted what’s known as an interpretative rule related to the Fair Credit Reporting Act, interpreting the law in a way that says the FCRA should preempt any state ...

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A Ticking Clock: How States Are Preparing for a Last-Minute Obamacare Deal

As shopping season opens for Affordable Care Act plans in some states, customers are confronting staggering costs for their health insurance next year. The extra federal subsidies put in place in 2021 that made coverage more affordable for millions of people will expire at the end of this year unless a gridlocked and idle Congress acts.

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Mark Cuban To Post Full Health Provider Contracts, Says It’s Key To Real Transparency

Mark Cuban, the billionaire entrepreneur and “Shark Tank” alumnus who started Mark Cuban Cost Plus Drugs, told senators on Wednesday that he thinks price transparency is critical to helping employers bring down the cost of health benefits. But Cuban said his Dallas-based online discount pharmacy is using its deep knowledge of health care pricing and ...

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California Hospitals Are Suing Over The State’s Efforts To Curb Their Spending

Hospitals argue that spending caps imposed by an affordability office will result in layoffs, cuts in health care services and reduced access to care for Californians.

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It’s ‘Too Late’ To Extend ACA Subsidies Without Major Disruptions, Some States And Lawmakers Say

States are worried Congress missed its opportunity to extend enhanced ACA subsidies and lower premiums before consumers start picking plans in a few weeks.

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Newly Passed California Laws Tackle Prior Authorization, Private Equity In Care And More

Changes to prior authorization, charity care screening and corporate influence in medicine are on the way for Californian healthcare organizations. Among the dozens of bills signed this week by Gov. Gavin Newsom ahead of an Oct. 12 deadline were several outlining new requirements or broader enforcement of healthcare practices. The new laws, as well as ...

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AstraZeneca Makes Deal With White House to Lower Drug Prices

AstraZeneca became the second drugmaker to enter a deal with the Trump administration to offer lower prices to Medicaid and to offer some of its drugs at a discount through TrumpRx, a government website to facilitate sales directly to consumers. “In other words the lowest price anywhere in the world, that’s what we get,” President Trump ...

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