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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.

Lack of Competition Leads to Higher ACA Plan Premiums in Rural Areas

The lower premiums in urban areas were partially connected to more competition among plans and providers. Having more plans also means they can spread the financial risk rather than having one or two payers shoulder all of it, leading to lower premiums.

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Playing On Fear And Fun, Hospitals Follow Pharma In Direct-To-Consumer Advertising

The scene is shadowy, and the background music foreboding. On the TV screen, a stream of beleaguered humans stand in an unending line.

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Primary Care Physician Visits Drop Among Patients with Employer Plans

NPs and PAs have recently taken on a larger role in primary care. Health experts say those roles will help fill primary care gaps in the coming years with physician shortages expected.

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Waiting on 2 States, CVS Delays Aetna Deal Closing Until After Thanksgiving

CVS expects to close its $69 billion acquisition of Aetna after the Thanksgiving holiday. 

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Democrats Won a Mandate on Health Care. How Will They Use It?

After House Democrats’ election triumph, Nancy Pelosi’s appraisal was clear: “Health care was on the ballot, and health care won.”

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The Robocallers that are Killing Benefit Advisers’ Reputations

The robots are calling, and it’s a nightmare for real healthcare brokers.

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Uncle Sam Wants You to Sit Less and Move More. Here’s How You Can Meet the New Exercise Guidelines

Listen up, Americans! The government has been recommending you get 150 minutes of exercise a week for a decade now. That’s just 20 minutes a day — and not even one in four of you can handle it.

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Express Scripts Ramps Up List-Price Pressure With Newfangled ‘Flex’ Formulary

During a yearslong examination of drug prices, there’s been no shortage of criticism for growing list prices, and in recent months, some companies have heard the talk and lowered their prices. Now, top PBM Express Scripts is rolling out a new formulary to help support the moves—and the plan could heap more pressure on players in competitive drug classes.

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Pelosi Says She’ll Be Speaker ‘to protect the Affordable Care Act’

House Minority Leader Nancy Pelosi (D-Calif.) said Sunday that she is "staying on as Speaker" to protect the Affordable Care Act.

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Breach of Obamacare Site Spilled Sensitive Data

More than two weeks after announcing that the Obamacare website, HealthCare.gov, had been hacked, the Department of Health and Human Services has revealed that the breach exposed a wealth of information, including partial Social Security numbers and immigration status.

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