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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.

Prices for Top-Selling Drugs Appear Immune to Common Market Forces: Study

A new study published in the Journal of the American Medical Association, which examined prices for the 49 top-selling drugs between January 2012 and December 2017, found virtually all of them rose in price on a regular basis. The median price among those drugs rose 76% over the time period, and 78% of the drugs in the study saw price hikes of at least 50%. More than 4 of 5 products in the study more than doubled in price. 

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Hospitals Accused Of Paying Doctors Large Kickbacks In Quest For Patients

For a hospital that had once labored to break even, Wheeling Hospital displayed abnormally deep pockets when recruiting doctors. To lure Dr. Adam Tune, an anesthesiologist from nearby Pittsburgh who specialized in pain management, the Catholic hospital built a clinic for him to run on its campus in Wheeling, W.Va. It paid Tune as much as $1.2 million a year — well above the salaries of 90% of pain management physicians across the nation, the federal government charged in a lawsuit filed this spring.

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Health Plan Satisfaction with Benefits Coverage is Rising

Consumers' overall satisfaction with their health plans is on the rise--but insurers continue to struggle with meeting key aspects of their customers' financial and personal health expectations.

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Will Drug Prices in TV Ads Really Be Transparent?

A website launched by pharmaceutical giant Eli Lilly LLY, +0.36%   earlier this year leads with a daunting statement about the price of its diabetes drug Trulicity: “Drug prices can be confusing,” it says. That’s for sure, and thanks to a new mandate from the Trump administration, consumers could find themselves even more confused.

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U.S. Healthcare Spending to Grow 4% in 2019

U.S. healthcare spending is expected to grow by 4% to $3.6 trillion this year while drug spending is expected to increase 2.5% to $370.7 billion, according to a new report from Fitch Solutions Macro Research, a unit of Fitch Group.

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White House Runs Into Health-Care Industry Hostility as it Plans Executive Order

President Trump is preparing to issue an executive order to foster greater price transparency across a broad swath of the health-care industry as consumer concerns about medical costs emerge as a major issue in the lead-up to next year’s presidential election.

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Health Tax Splits California Amid Need for Trump’s Approval

California lawmakers are headed toward a confrontation with Gov. Gavin Newsom over whether to keep a tax that can generate nearly $2 billion for low-income health benefits but means approval from the Trump administration amid a feud between state and federal officials.

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Key Health Bill Draft Includes Agent Comp Disclosure Section

A top Republican and a top Democrat in the U.S. Senate have put a long health insurance agent and broker compensation disclosure provision in a major new health care finance system change bill.

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Health Care Tops List of Americans’ Top Issues in New Poll

Health care is the top issue for Americans, according to a new poll from RealClear Opinion Research.

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13M Americans Spent 10% of Income on Insurance Premiums in 2016-17

Researchers at the Commonwealth Fund examined out-of-pocket spending totals for people with private health insurance and found a large portion of the country was spending 10% or more of their household income on insurance costs.

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