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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.

Employers Jump Into Providing Care As Health Costs Rise

Autoworkers in this blue-collar, central Indiana city have an eager helper waiting to pick up the bill at their next doctor visit.

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Immigrants’ Health Premiums Far Exceed What Plans Pay For Their Care

President Donald Trump has repeatedly condemned U.S. immigration policy, arguing that many immigrants pose a threat to the nation and drain U.S. resources. But a study released Monday about health insurance challenges the president’s portrayal.

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Drugmakers Play The Patent Game To Lock In Prices, Block Competitors

David Herzberg was alarmed when he heard that Richard Sackler, former chairman of opioid giant Purdue Pharma, was listed as an inventor on a new patent for an opioid addiction treatment.

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Feds Settle Huge Whistleblower Suit Over Medicare Advantage Fraud

One of the nation’s largest dialysis providers will pay $270 million to settle a whistleblower’s allegation that it helped Medicare Advantage insurance plans cheat the government for several years.

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Lawmakers Unveil Massive Bipartisan Bill Aimed at Fighting Opioid Crisis

Bipartisan congressional leaders in both chambers on Tuesday night unveiled a massive bill aimed at fighting the epidemic of opioid abuse in the United States, capping months of work.

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Nevada Policy Issues Regarding Leaving Obamacare Exchange

Nevada’s program, called Nevada Health Link, is scheduled to go into operation by 2020. The Affordable Care Act gave states a choice between joining the federal health insurance exchange or administering their own versions, called state-based marketplaces (SBMs). Nevada, along with five other states, had been operating a blended form that placed an independently managed state-based marketplace on the federal tech platform.

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Medicaid Spending Hit $581B in 2016. Here’s How Its Projected to Grow Over the Next Decade

Medicaid provided healthcare coverage to 72.2 million people in fiscal year 2016, an increase of 3.1% over 2015.

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Will Congress Bring Sky-High Air Ambulance Bills Down To Earth?

Air ambulance rides are literal lifesavers. But how much should they cost? In the ongoing, crowdsourced “Bill of the Month” investigation, Kaiser Health News and NPR received more than a dozen bills from people around the country on the hook for medevac helicopter rides that ranged from $28,000 to $97,000.

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As States Try To Rein In Drug Spending, Feds Slap Down One Bold Medicaid Move

States serve as “laboratories of democracy,” as U.S. Supreme Court Justice Louis Brandeis famously said. And states are also labs for health policy, launching all kinds of experiments lately to temper spending on pharmaceuticals.

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5 Things To Know About Trump’s New ‘Public Charge’ Immigration Proposal

A proposed rule from the White House would make it harder for legal immigrants to get green cards if they have received certain kinds of public assistance — including Medicaid, food stamps and housing subsidies. Green cards allow them to live and work permanently in the United States.

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