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.
The hospital lobby has scored a court-ordered pause on the federal government’s 340B Rebate Model Pilot Program just days before it was set to begin. On Dec. 29, U.S. District Judge Lance Walker, the chief of the U.S. District Court for the District of Maine, ordered a preliminary injunction against the “hastily assembled” pilot set ...
Lawmakers have introduced a bipartisan bill that could apply Employee Retirement Income Security Act fiduciary requirements to employer health plans’ pharmacy benefit managers. The bill, the PBM Fiduciary, Accountability, Integrity and Reform Act, or PBM FAIR Act, would add a PBM fiduciary section to ERISA section 3(21), according to a version of the text posted by Sen. Roger ...
UPDATED: 7:45 p.m. on Dec. 17 The House of Representatives passed a Republican-led package that seeks to address the affordability of healthcare without an extension of the soon-to-expire Affordable Care Act subsidies. The 216-211 vote averted a last-ditch effort from Democrats and several moderate Republicans to force a vote on a subsidy extension. All Democrats ...
Four House Republicans who are worried about the Affordable Care Act health insurance “subsidy cliff” are trying to help House Democrats force a vote by the full House on a subsidy extension bill. The Republicans today signed a discharge petition that calls for the House to bring a subsidy extension resolution up for a vote ...
As Congress debates whether to extend the temporary federal subsidies that have helped millions of Americans buy health coverage, a crucial underlying reality is sometimes overlooked: Those subsidies are merely a band-aid covering the often unaffordable cost of health care. California, Massachusetts, Connecticut, and five other states have set caps on health care spending in a bid to rein ...
The FDA’s oversight of medical device recalls continues to be plagued by staffing challenges—forcing some activities to be placed on the “back burner” and resulting in lengthy response times, according to a new report from the U.S. Government Accountability Office (GAO). The GAO published its findings this week after an 18-month-long performance audit of the agency conducted ...
This year kicked off with a new administration heralding big policy changes in areas that affect employee health & welfare benefits. This year’s Roundup is packed with the latest legislative and regulatory developments that matter most to health benefit plan sponsors and service providers. From significant consumer-directed health legislative changes in telehealth and health savings ...
The House of Representatives unanimously voted to pass a bill Monday that extends the Medicare hospital at home program for five years. Hospital at home providers have been mired in uncertainty for years. Though Congress has repeatedly extended hospital at home flexibilities, it often only does so for a handful of months at a time. ...
The president injected more uncertainty last week, saying he doesn’t want to extend key insurance subsidies but understands it might be necessary.
The Trump administration is proposing significant changes to the metrics used to the calculate the Medicare Advantage star ratings. As part of the Contract Year 2027 MA and Part D proposed rule, the Centers for Medicare & Medicaid Services has pitched that the Excellent Health Outcomes for All award, known previously as the Health Equity ...