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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 Offers Health Care To Undocumented Residents. A Republican Lawmaker Wants To End It

The bill’s introduction comes days before Gov. Gavin Newsom would present his plan for closing the state’s $68 billion budget deficit. Newsom has repeatedly cited his commitment to protecting the expansion, which is estimated to cost $4 billion per year.

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What Type of Worker Are You? Government Has New Test for Who Should Be on Payroll

New Biden administration rule could impose stricter test for Uber, Lyft and others to classify workers as contractors

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Hospital, Payer Price Transparency Compliance Improves, But New Requirements Are Kicking In This Year

A “pivotal year for price transparency” closed out with most—but not all—of the healthcare industry publishing their data publicly and at a higher quality, price transparency data startup Turquoise Health wrote in a state-of-the-industry report released Thursday.

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ACA IRS Reporting Overview 2024

Employers that were considered “Applicable Large Employers (ALEs)” in 2023 must file IRS reports by April 1, 2024, detailing their compliance with the ACA’s employer mandate. ALEs must generate a report for each person employed full time for at least one full calendar month of 2023.

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IRS’ 2024 Inflation Adjustments Review: Key Changes For Plan Administrators

The IRS announcements include a number of dollar amounts employers will need to know in order to administer their benefit plans for 2024, including the key dollar amounts for retirement plans, FSAs, HSAs and HDHPs.

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2024 Outlook: Drug Price Negotiations, Braidwood Highlights Top Legal Cases To Watch

Legal experts indicated they will be paying close attention to lawsuits surrounding the Medicare drug price negotiation program and Braidwood v. Becerra. Both topics could have massive ramifications on the healthcare industry and set new precedents.

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‘You Have A Crisis Out There’: Gavin Newsom Scolds Counties Over Delays In Mental Health Law

If any year is looked back on as pivotal in California’s fight to curb mental illness, homelessness and drug-related deaths, 2023 could be the one. Gov. Gavin Newsom pushed major — and at times controversial — reforms of the state’s mental and behavioral health systems through the Legislature, but a mere two months after signing the laws, ...

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FTC, DOJ, HHS’s New Health Counsels To Take On Price-Gouging

Three major government agencies are adding new officials to investigate price-gouging in health care — positions experts say will help the three agencies better coordinate across the government.

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Biden Administration To Impose Inflation Penalties On Dozens Of Drugs

The Biden administration said on Thursday it had identified 48 drugs in the Medicare program whose prices rose quicker than inflation during the fourth quarter of the year and may require their makers to pay rebates.

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CMS Finalizes Updated Fees For No Surprises Act Dispute Resolution

The Biden administration on Monday released amended fees related to independent dispute resolution under the No Surprises Act. The Centers for Medicare & Medicaid Services had established initial fees, but the guidance was vacated by a Texas judge in a win for providers, forcing the agency to pause IDR. The independent dispute resolution approach is ...

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