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.
Many Republicans assume their party will take another stab at repealing and replacing the Affordable Care Act if the midterm elections go their way, even though GOP candidates aren't making a big deal about it on the campaign trail.
Humana has filed a lawsuit against more than two dozen pharmaceutical companies for conspiring to fix the prices of widely used generic drugs, a scheme that forced the insurer to pay for drugs at artificially inflated prices.
California Insurance Commissioner Dave Jones is asking federal regulators to block a pending $69 billion CVS-Aetna merger.
CMS on Thursday issued its final rule on the Inpatient Prospective Payment System, cementing the agency's April proposal to increase transparency by pushing hospitals to post standard charges online in a machine-readable format.
The Trump administration on Wednesday cleared the way for insurers to sell short-term health plans as a bargain alternative to pricey Obama-law policies for people struggling with high premiums.
Enrollment in the individual health insurance market — the market for people who don't get coverage through work — has declined 12 percent in the first quarter of 2018, compared to the same period last year, according to a new analysis released Tuesday.
It came as something of a surprise when Health and Human Services Secretary Alex Azar announced that the administration was exploring the importation of prescription drugs to fight high domestic prices. Azar and Scott Gottlieb, commissioner of the Food and Drug Administration, who also endorsed the new proposal, had previously opposed the idea.
Think President Donald Trump's proposal to slap price tags on drug advertising is all talk and no action? Think again. Over the past couple of weeks, the idea has gained steam—and bipartisan backing, including from Democrats often critical of the president. So much so, in fact, that a bill containing the provision could see a Senate vote this week.
As the CMS charts a path to level pay for outpatient services, it's also leading toward a head-to-head battle with powerful hospital lobbying groups as some providers win and lose with site-neutral payments.
The U.S. is grappling with how to rein in high drug prices. Unfortunately, most of the proposed solutions work better on a bumper sticker than in reality. The debate, however, tends to ignore a key player -- the prescribing doctor -- who could have a central role in a more sustainable approach to better value in drug pricing.