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.
Three major government agencies are adding new officials to investigate price-gouging in health care — positions experts say will help the three agencies better coordinate across the government.
The Biden administration said on Thursday it had identified 48 drugs in the Medicare program whose prices rose quicker than inflation during the fourth quarter of the year and may require their makers to pay rebates.
The Biden administration on Monday released amended fees related to independent dispute resolution under the No Surprises Act. The Centers for Medicare & Medicaid Services had established initial fees, but the guidance was vacated by a Texas judge in a win for providers, forcing the agency to pause IDR. The independent dispute resolution approach is ...
The Biden administration plans to push states to boost oversight of the number of doctors, hospitals, and other health providers insurers cover in Obamacare plans, under rules proposed in November. The annual regulatory proposal, known as the payment parameters rule, also seeks to expand access to adult dental coverage in Affordable Care Act marketplaces and ...
A House vote on transparency regulations in healthcare could occur next week, potentially having substantial ramifications on how PBMs and hospitals operate.
The House passed a relatively major health care package late Monday, an end-of-year victory after the same policies had to be yanked from consideration in September because they lacked bipartisan support.
The start of each year marks an important date for employers as they face annual compliance responsibilities related to their health plans, the Affordable Care Act (ACA), and COBRA. Staying on top of these regulations is crucial for compliance and to avoid significant non-compliance penalties.
Recent disruptions in OpenAI’s top brass have sparked intense dialogue within the healthcare sector, emphasizing the urgent need for robust standards governing the implementation of generative AI technologies. With Microsoft recruiting former OpenAI executives Sam Altman and Greg Brockman, concerns are growing that few corporations may soon dictate the trajectory of healthcare AI, potentially molding ...
A health Flexible Spending Account (FSA) is an employer-sponsored benefit that allows eligible employees to save pre-tax dollars to pay for qualified medical expenses. Employees can elect a specific dollar amount, up to a certain limit, to set aside annually.
The House Committee on Energy and Commerce health subcommittee pushed forward 21 proposals on Tuesday, some of which will restrict the power of pharmacy benefit managers (PBMs). Democrats supported many of the proposals put forward by Republicans, including legislation reining in PBMs that had support from 60 organizations representing patients, providers, pharmacists, small businesses and ...