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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.

Trump Says He Got Rid of Obamacare. The I.R.S. Doesn’t Agree

At a rally in Michigan a little over a week ago, President Trump assured his supporters that he had kept his promise to abolish the Affordable Care Act — even though Congress had failed to repeal the Obama-era health law.

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Poll Finds 4M Lost Health Insurance in Last Two Years

About 4 million Americans lost health insurance in the last two years, according to a new survey from the Commonwealth Fund, which attributed the decline to actions taken by the Trump administration.

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As Specialty Drugs Gain Share, Trump Looks To Curb Prices

The share specialty drugs have of total U.S. pharmaceutical sales is hurtling toward 50% just as the Donald Trump White House prepares next week to unveil proposals to curtail the nation’s tab for prescription drugs.

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Industry Voices—Why insurers are spending billions to acquire physician practices

A couple of giant proposed healthcare mergers have garnered a lot of attention in recent months. People want to know what CVS’ $69 billion deal for Aetna or Cigna’s $52 billion agreement to buy Express Scripts can tell us about the future of U.S. healthcare.

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Tom Price: ObamaCare mandate repeal will drive up costs

Former Secretary of Health and Human Services Tom Price on Tuesday said that the repeal of ObamaCare’s individual mandate would drive up costs, a remark seized on by Democrats.

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Medicare’s proposed direct-contracting model carries both rewards and risk

A new direct provider contracting model under consideration at the CMS could potentially save providers billions in administrative costs, but could also threaten access to care for Medicare's frailest and lowest-income beneficiaries.

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Insurer Anthem’s Earnings Jump 30 Pct as Medical Costs Fall

The nation's second-largest health insurer joined rival UnitedHealth Group Inc. in topping analyst expectations for the quarter and hiking its 2018 forecast. Anthem said Wednesday that it now expects 2018 adjusted earnings to be greater than $15.30 per share after saying in January that they would exceed $15 per share.

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Democrat introduces bill to allow auto-enrollment in Obamacare

A California Democrat has introduced a proposal for Obamacare that Senate Republicans backed during their repeal and replace efforts last year. The legislation from Rep. Ami Bera would allow states to set up programs that automatically enroll people in Obamacare plans or in Medicaid, depending on which programs they qualify for. People would have 60 days to opt out of the health insurance.

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Personalized, progressive employee health offerings on the rise

The percentage of employers offering telemedicine shot up 24% in the last year, from 49% in 2016 to 73% in 2017, while the number of firms offering employees access to a 24-hour nurse line increased 10%, from 69% to 79%, according to the report, which surveyed more than 850 WorldatWork members.

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More young, high-income men have coverage under the ACA despite predictions they would flee the market

Changes to insurance regulations under the Affordable Care Act (ACA) were supposed to drive young, healthy men with higher incomes from the insurance market. But according to a study published earlier this month, that didn’t happen. In fact, uninsured rates dropped significantly among young, healthy men during the first few years of ACA implementation

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