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.
Large drug makers and the industry’s primary trade group neared previous spending records on lobbying in the first three months of the year as President Donald Trump and Congress increased pressure to rein in the cost of medicine.
CMS is taking aim at increasing the use of generic drugs in ACA plans in a new rule filed Thursday evening.
The White House and top lawmakers from both parties think a bill to lower drug prices has a better chance of becoming law before the 2020 election than any other controversial legislation.
The CMS finalized a rule on Thursday that would allow health insurers to implement copay accumulator programs to prevent drug manufacturer coupons from applying to a patient's annual limit on out-of-pocket costs in situations where a generic drug is available.
The Congressional Budget Office has announced that it will be using a new model for budget projections that will account for new consumer and employer preferences when it estimates how proposed legislation will affect insurance coverage and premiums.
Emergency department visits have continued to rise even as more Americans gained health insurance after the Affordable Care Act came into play, according to a new study.
Workplace wellness programs have become an $8 billion industry in the U.S. But a study published Tuesday in JAMA found they don’t cut costs for employers, reduce absenteeism or improve workers’ health.
In 2017, Susan learned that she carries a genetic mutation that may elevate her lifetime risk of developing breast cancer to 72 percent. Her doctor explained that individuals who have this mutation in the BRCA2 gene have choices in treatment. Some people opt for a preventive double mastectomy. But Susan could instead choose to undergo increased cancer screenings, which, for her, would mean an annual mammogram and annual MRI scan.
When Josh Riff was leading benefits for Target, he found himself increasingly frustrated that he wasn’t able to take more of a lead when it came to managing the healthcare of his employees. “All the ideas, all the innovation, everything came through [our carrier],” he says. “We were on the hook to pay for our healthcare, but we weren’t doing anything proactive to change the trend or the curve except for what our provider was telling us to do.”
The CEO of the nation's largest health insurer on Tuesday sharply criticized "Medicare for all" proposals being debated by Democratic lawmakers and presidential hopefuls, weighing in on a major political fight ahead of the 2020 election.