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.
In a major victory for patients who depend on prescription drugs, Judge John D. Bates of the U.S. District Court for the District of Columbia struck down a Trump administration federal rule that allowed health insurers to not count drug manufacturer copay assistance towards a beneficiary’s out-of-pocket costs. The case was brought against the U.S. Department of Health and ...
Amid a flurry of partisan roadblocks rolling out across Capitol Hill, representatives on both sides of the aisle came together Tuesday to critique federal agencies’ rollout of the No Surprises Act and throw their support behind court-ordered rewrites of independent dispute resolution (IDR) regulations. During a hearing exploring the “flawed implementation” of the law intended ...
The dramatic impact of medical debt on credit scores may soon be a thing of the past. On Thursday, the White House announced a plan outlined by the Consumer Financial Protection Bureau (CFPB) to eliminate medical debt from credit reports. The move — which follows an earlier decision from the three main credit bureaus to eliminate paid medical debt, medical ...
The Consolidated Appropriations Act (CAA) of 2021 made a number of federal changes to the U.S. health care system, with the goal of increasing transparency. One of the most immediate changes was the prohibition of gag clauses in contracts between insurance plans, insurance issuers, and providers. Gag clauses are contractual provisions that restrict plans or ...
Throughout the year, especially during Q4, we know you are bound to have questions about Underwriting, Client Experience, Enrollment, and Compliance. That’s why we’ve compiled this list of the most frequently asked questions (FAQs) during peak season.
A trio of House committees unveiled new legislation (PDF) Friday to lower costs and increase transparency for patients. The Lower Costs, More Transparency Act includes provisions from the House Energy and Commerce Committee, the Ways and Means Committee and the Education and the Workforce Committee and is designed to help patients be more informed when making healthcare decisions regarding ...
All employers offering prescription drug benefits to employees are required to provide annual notifications to Medicare-eligible employees and dependents before October 15th, regarding the drug status of their plan(s).
Hospitals are on board with the Biden administration’s increased scrutiny of “inadequate” short-term health plans, and are hoping that the federal government will go further in its crackdown on payers’ “convoluted policies.” In early July, the White House said it was working to reverse a controversial Trump-era rule that expanded the duration of the controversial ...
Many steps remain before older adults see the benefit of the Centers for Medicare and Medicaid Services’ upcoming talks with drugmakers.
The national Covid emergency has ended, but a new strain of the coronavirus, called EG.5 or “Eris,” is rapidly circulating worldwide. “EG.5 is actually just a subvariant of omicron,” says Dr. Payal Patel, infectious diseases physician at Intermountain Health in Salt Lake City. “We are seeing a rise in this subvariant worldwide. We’re seeing it in the U.S. ...