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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.

Breakthrough Made On Surprise Billing Legislation

If it pays off, this could be the biggest breakthrough of the year, vis-à-vis medical bills: movers and shakers in both the House and Senate have reached agreement on legislation to tackle surprise medical bills.

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Obamacare Back at the High Court – With Billions for Insurers on the Line

More than $12 billion is at stake for the nation’s health insurers Tuesday when the Supreme Court hears another Affordable Care Act case.

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Pelosi Drug Pricing Plan Would Save $456 Billion Over Ten Years: Analysis

House Speaker Nancy Pelosi's bill that would let Medicare negotiate prices with drug companies would save the government $456 billion over ten years, according to an analysis released Tuesday.

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Health Insurance Tax Helped Drive Health Spending in 2018

Health care spending grew last year but shrunk as a portion of overall spending. A new analysis published in Health Affairs by Micah Hartman, a statistician in the CMS Office of the Actuary, finds that national health care spending increased by 4.6 percent in 2018 to $3.6 trillion, or 17.7 percent of the overall economy. That’s down from 17.9 percent the previous year.

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Prescription Drug Prices Down Slightly Last Year

Prices for prescription drugs edged down by 1% last year, a rare result driven by declines for generics and slow, low growth in the cost of brand-name medications, the government said Thursday.

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CMS Administrator Seema Verma Scoffs at Hospital Execs’ Arguments Against Transparency

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma pushed back on hospitals' resistance to publishing payer-negotiated prices, as now mandated by a federal rule.

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Website Errors Raise Calls For Medicare To Be Flexible With Seniors’ Enrollment

Saturday is the deadline for most people with Medicare coverage to sign up for private drug and medical plans for next year. But members of Congress, health care advocates and insurance agents worry that enrollment decisions based on bad information from the government’s revamped, error-prone Plan Finder website will bring unwelcome surprises.

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Trump Pulled Into Feud Between Top Health Officials

President Donald Trump has personally tried to settle the long-running feud between his two top health appointees, telling his health secretary to fix the relationship with his Medicare chief, said three individuals with knowledge of the situation.

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Employers, Insurers, Unions Urge Full Repeal of Cadillac Tax

More than 1,000 employers, insurers, unions, and other organizations on Thursday urged Senate leaders to scrap a controversial tax on expensive employer-sponsored health plans that's set to go into effect in 2022.

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Medicare Advantage Members Rarely Review or Switch Plans

Very few beneficiaries with Medicare Advantage or Medicare Part D stand-alone coverage voluntarily switch plans during open enrollment, according to a report from the Kaiser Family Foundation.

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