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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.

Debate Over Third-Party Payments for Dialysis Patients Revived in Washington as Calif. Eyes Limits

The fight over third-party premium assistance for dialysis patients is heating up this week in California and Washington, D.C. as employers and labor unions get involved.

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Universal Coverage Bills Move Forward, With Questions

A bill that would expand health care coverage to undocumented adults has moved forward in the California state Assembly, part of a push by Democratic lawmakers to create universal coverage, after a single-payer bill stalled last year.

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4 New Ways You Can Avoid Fines For Not Having Health Insurance

There are already more than a dozen reasons people can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more “hardship exemptions” that let people off the hook if they can’t find a marketplace plan that meets not only their coverage needs but also reflects their view if they are opposed to abortion.

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Drug Company “Shenanigans” to Block Generics Come Under Federal Scrutiny

Trump administration officials, seeking ways to lower drug costs, are targeting pharmaceutical companies that refuse to provide samples of their products to generic drug companies, making it impossible to create inexpensive generic copies of a brand-name medicine.

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Health Savings Accounts and High Deductible Plans Maintain Steady Enrollment Growth

Health savings accounts coupled with high deductible plans have seen a major enrollment boost in recent years, according to new data from America's Health Insurance Plans (AHIP) .

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CVS Hires Doctor From Health Startup in Sign of Medical Ambition

CVS Health Corp. is hiring a senior executive from a startup that specializes in primary-care clinics, a sign that the drugstore chain is serious about providing more medical services directly to consumers as it moves toward acquiring health insurer Aetna Inc. 

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Pharmacies Surge On Report That Amazon Is Backing Away From Prescription Drugs

Rumors have been swirling that Amazon might try to break into the pharmacy business. On Monday, CNBC reported that Amazon (AMZN) has put its plans to sell and distribute pharmaceutical products on hold. An Amazon representative told CNNMoney that the company does not comment on rumors or speculation.

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5 Takeaways From CMS’ Final 2019 ACA Marketplace Rule

The CMS issued a 523-page final rule late Monday that agency officials said is meant to give states more power to regulate their individual and small-group health insurance markets. The rule also furthers the Trump administration's agenda of chipping away at Affordable Care Act rules in lieu of a full repeal, which congressional Republicans haven't been able to pull off.

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Senator Says Pharma Should’ve Cut Prices With Tax Savings, But Many Companies Went The Other Way

Many top drugmakers reaped savings from U.S. tax reform, which lawmakers touted as a boon that would deliver jobs and other benefits. In pharma, tax savings and cash brought home from abroad could have lowered costs for patients—or so one senator's reasoning goes.

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Insurers Look to Pass Drug Price Breaks Straight to Consumer

Some major health insurers plan to take a little sting out of prescription drug prices by giving customers rebates at the pharmacy counter. Aetna and UnitedHealthcare both say they will begin passing rebates they get from drugmakers along to some customers starting next year. They could spark a trend: The idea has been championed by President Donald Trump, and it’s something other bill-payers like major employers might consider.

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