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.
Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators. The Centers for Medicare & Medicaid Services, which oversees the ACA, credits steps taken to thwart enrollment and switching problems that triggered more than 274,000 complaints ...
Those ever-present TV drug ads showing patients hiking, biking or enjoying a day at the beach could soon have a different look: New rules require drugmakers to be clearer and more direct when explaining their medications’ risks and side effects. The U.S. Food and Drug Administration spent more than 15 years crafting the guidelines, which are ...
The Drug Enforcement Administration and Health and Human Services ended an impasse over the virtual prescribing of controlled substances that threatened access to drugs like Adderall by extending pandemic-era flexibilities through the end of 2025. Why it matters: Keeping the status quo leaves the question of whether to make controlled substances available without an in-person doctor’s visit for ...
Former President Donald Trump’s election victory and coming return to the White House will likely bring changes that scale back the nation’s public health insurance programs — potentially increasing the uninsured rate.
A new Trump administration could dramatically alter the Affordable Care Act through either massive changes, technical fixes, or cuts to subsidies and protections.
States may be getting ready to crack down even harder on pharmacy benefit managers. The National Association of Insurance Commissioners will be giving member regulators a crash course on PBM policy next week in Denver, at the NAIC’s fall national meeting. PBMs help health insurers and self-insured employer health plans cover prescription drugs. One NAIC ...
The Affordable Care Act (ACA) requires fully insured Small Group medical plans to offer an annual one-month Special Open Enrollment (SOE) Window. This period, which runs from November 15 to December 15 annually, allows eligible Small Group employers to enroll in medical coverage without needing to meet the usual contribution or participation requirements. Group coverage obtained during the SOE ...
Legislation signed into law by California Governor Gavin Newsom on September 24, 2024 will subject commercial debt collectors to new compliance requirements starting in 2025.
The IRS has announced new 401(k) contribution limits for 2025. In its release Friday, the agency increased the employee deferral limit to $23,500, up from $23,000 in 2024. The change applies to workplace plans, including 401(k)s, 403(b)s and most 457 plans, along with the federal Thrift Savings Plan. The IRS also unveiled 2025 catch-up contribution limits for savers age ...
The federal hospital price transparency rules adopted in 2021 have been doing more to cut prices than to spur the cheapest hospitals to raise their rates, according to analysts at Turquoise Health.