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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.

For 2020 Dem Hopefuls, ‘Medicare-For-All’ Is A Defining Issue, However They Define It

Democrats with 2020 presidential aspirations are courting the party’s increasingly influential progressive wing and staking out ambitious policy platforms.

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Costly Specialty Drugs Drive Higher Spending on Provider-Administered Treatments, Study Finds

Spending per member in commercial plans on medical pharmacy drugs increased by nearly 20% between 2016 and 2017, due in part to the growing number of emerging therapies with high price tags. 

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HHS Using Disclosure Transparency to Try to Force Change

To get healthcare's powerful players to behave as desired, HHS and its various units are increasingly turning to the same playbook: naming and shaming bad actors.

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Hospital Mergers Improve Health? Evidence Shows the Opposite

Many things affect your health. Genetics. Lifestyle. Modern medicine. The environment in which you live and work.

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Americans Cross Border Into Mexico To Buy Insulin At A Fraction Of U.S. Cost

When Michelle Fenner signed up to run this year’s Los Angeles Marathon, it got her thinking: Tijuana, Mexico, is only a 2½-hour drive from L.A. Why not take a trip across the border and buy some insulin for her son?

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3 Tips To Ensure Clients Are In Compliance

The rise of the contract workforce in cities across the nation, and questions about whether these workers are eligible to access company-sponsored health benefits, has created confusion. It is up to advisers to stay on top of health insurance regulations to protect clients from unexpected compliance-related stress and financial penalties.

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Supplement Makers Touting Cures for Alzheimer’s and Other Diseases Get F.D.A. Warning

The Food and Drug Administration on Monday warned 12 sellers of dietary supplements to stop claiming their products can cure diseases ranging from Alzheimer’s to cancer to diabetes.

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Medicare, Medicaid Better Than Private Insurers at Containing Costs, Study Finds

Medicare and Medicaid are better than private insurers at keeping spending per-beneficiary low, a finding that has crucial implications for the current health policy debate, according to a new report.

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Hospital Lobby Ramps Up ‘Medicare for All’ Opposition

Hospital lobbies are mounting a coordinated effort to dissuade legislators from supporting Medicare for all, a policy health systems argue would cut into profits and ultimately force facilities to shutter. 

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Hospital Prices, Not Physicians, Drive Cost Growth, Health Affairs Says

The American Hospital Association pushed back on the Health Affairs findings in a statement Tuesday afternoon, saying the authors "use limited data to draw broad conclusions." AHA President Tom Nickels noted that the study uses data from employer-sponsored plans and doesn't include Medicare, Medicaid or Blue Cross Blue Shield claims.

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