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.
Tim Ebel’s visit with an ear, nose and throat specialist at an Ohio clinic last October came to $348. At the same time, he got a second bill for $645. The hospital system that owns the Avon, Ohio, clinic had charged him separately for use of the office where he met his physician. It is ...
More than 100 provider organizations want the Centers for Medicare & Medicaid Services (CMS) to take a tougher stance on Medicare Advantage (MA) plans’ practices following an industry survey estimating billions per year are spent fighting claims denials. Providers spent nearly $20 billion in 2022 pursuing delays and denials across all payer types, yet those ...
The administration said his budget (PDF) will lower healthcare costs and drug prices, expand access to prescription drugs, build upon the Affordable Care Act (ACA) and fortify Medicare through a tax on the wealthy. Many of these priorities were previewed during Biden's State of the Union address last week.
The US government on Sunday urged insurance companies to make advanced payments to health care providers following a cyberattack that disrupted insurance processing systems. The cyberattack had “significant impact” on Change Healthcare, a unit of health IT giant UnitedHealth Group, which processes 15 billion health care transactions annually. CNN previously reported that the cyberattack has resulted ...
For now, insurers and employers are still not required to cover certain free preventive care services, such as cancer screenings and HIV-preventing medications, until the federal appeals court makes its decision later this year.
California Attorney General Rob Bonta announced Monday that he is throwing his weight behind legislation to bar medical debt from showing up on consumer credit reports, a Democratic-led effort to offer protection to patients squeezed by health care bills. Bonta is a sponsor of Sen. Monique Limón’s bill, which seeks to block health care providers, as ...
As the disruption caused by the cyberattack at Change Healthcare stretches beyond its tenth day, cybersecurity experts say the incident could spur greater emphasis on enhancing protocols—and greater oversight from the feds.
With access that millions of Americans have to preventive care at stake, a conservative federal appeals court on Monday picked apart how the Biden administration has tried to maneuver around the latest significant challenge to Obamacare.
A bipartisan spending bill unveiled Sunday narrows some of this year’s cuts to physician Medicare pay, pushes back scheduled disproportionate share hospital (DSH) payment cuts and increases annual funding for community health centers, among other provisions that would prevent a partial government shutdown on March 8, if signed. The 1,050-page deal (PDF) between red and blue ...
State attorneys general are urging Congress to pass three bills that would reform pharmacy benefit manager practices and bring more transparency to their work. A bipartisan group of 39 state attorneys general sent a letter to Senate and House leaders Feb. 20, highlighting the urgent need for federal action. While efforts to regulate PBMs are occurring on the state ...