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 Trump administration said it will seek stiffer penalties against drug dealers — including the death penalty where appropriate under current law — and it wants the number of prescriptions for powerful painkillers to be cut by one-third nationwide as part of a broad effort to combat the opioid crisis.
A leading liberal health-care advocacy group is warning against a proposal to fund ObamaCare payments, saying the move would actually harm consumers. The group, Families USA, is opposing a plan released on Wednesday from Sen. Lamar Alexander (R-Tenn.) in large part because the proposal would fund ObamaCare payments known as cost-sharing reductions (CSRs).
Coupons, which are used to get steep discounts, typically come in the form of cards that consumers get in drug ads or from doctors. Coupons help drug companies sell more products, but studies show coupons also raise health care costs because they encourage people to buy more expensive drugs, even when cheaper generics are available. Insurance companies, therefore, don’t think much of coupons.
Health insurer Cigna is buying the nation’s biggest pharmacy benefit manager, Express Scripts, the latest in a string of proposed tie-ups as health care’s bill payers attempt to get a grip on rising costs.
The practice of charging a copay that is higher than the full cost of a drug is called a “clawback” because the middlemen that handle drug claims for insurance companies essentially “claw back” the extra dollars from the pharmacy.
The House rejected legislation Tuesday easing how experimental drugs are provided to people with terminal illnesses, as Democrats calling the bill risky and misleading overcame support from President Donald Trump and emotional arguments by Republican lawmakers and ailing constituents.
In April, the government will start sending out new Medicare cards, launching a massive, yearlong effort to alter how 59 million people enrolled in the federal health insurance program are identified.
Betty Doumas-Toto's health insurance premium rose nearly 48 percent in January, to $800 per month for an Affordable Care Act plan. She and her husband are both Los Angeles freelancers in the film industry and are draining their savings trying to keep up with their monthly payments.
A supporter of two Obamacare stabilization bills cited a new analysis showing premiums will decrease due to the legislation amid attacks from outside groups that call the bills “bailouts.”
A smartphone app that lets Medicare patients access their claims information. Giving consumers a share of drug company rebates for their prescriptions. Wider access to websites that reliably compare cost and quality of medical tests.