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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.

The Biden Administration Will Hang on to Some COVID Pandemic Emergency Powers

Even though the Biden administration is ending its highest-profile Covid-19 emergency declaration next month, it’s still going to hold on to some pandemic-era powers. The Department of Health and Human Services gave governors a heads-up on Friday that it is planning to keep pharmacists’ ability to administer Covid-19 and flu vaccines past the end of ...

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Electronic Health Records Rule Sets Up “Bridge to Nowhere” Insurers Say

A Biden administration effort stemming from the 21st Century Cures Act to make health data sharing more transparent is facing pushback from health insurers. Why it matters: The rule from the Office of the National Coordinator for Health Information Technology aims to get providers and payers to share patient health information in a more seamless way. But health ...

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Employers Should Review Common Severance Agreement Terms Due to New NLRB Decision

Historically, employers have routinely included confidentiality and non-disparagement provisions in severance agreements with departing employees. Such provisions can be important for protecting sensitive personnel data or proprietary business information from disclosure. But in light of a recent National Labor Relations Board (NLRB) decision, employers in both unionized and non-union workplaces should review their agreements and consider ...

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Study Finds Half Of Cash Prices Below Commercial Rates In More Than 2,000 Hospitals

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.

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What Lies Ahead for ACA’s Preventive Care Coverage Mandate?

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.

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Medi-Cal Will Soon End Some People’s Benefits. What This Means For You

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 ...

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Biden Signs Bill Ending COVID-19 National Emergency

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 ...

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Joint Statement from California Health & Human Services Leaders on Affordable Care Act Federal Ruling

“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.

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Judge’s Ruling Undercuts U.S. Health Law’s Preventive Care

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.

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Compliance Alert: Most Employers Are Required to File Electronic Information Returns Beginning in 2024

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.

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