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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.

GOP Scraps Individual Mandate But Sets Up New Penalty For Those Skipping Coverage

The Affordable Care Act’s tax penalty for people who opt out of health insurance is one of the most loathed parts of the law, so it is no surprise that Republicans are keen to abolish it. But the penalty, called the individual mandate, plays a vital function: nudging healthy people into the insurance markets where their premiums help pay for the cost of care for the sick. That has required Republican lawmakers to come up with an alternative.

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House Republicans Recycle Controversial 2003 Bill To Boost Small-Business Insurance

In a bid to improve the health insurance purchasing clout of small businesses, Republicans have dusted off a piece of controversial legislation more than a decade old and reintroduced it as part of their effort to remake the market after they throw out the Affordable Care Act.

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Ryan: More Help for Older People Needed in GOP Health Bill

Days before a pivotal vote, House Speaker Paul Ryan said Sunday he will seek changes to a GOP health care bill to provide more help to older people. The new willingness to compromise was a bid for more support from moderate Republicans, who expressed continuing unease about the plan to replace Barack Obama's health law unless significant changes were made.

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Republicans Tweak Obamacare Bill as Trump Moves to Promote Overhaul

Congressional Republicans recrafted their Obamacare replacement bill on Monday in hopes of satisfying critics as U.S. President Donald Trump prepared to promote his first major legislative initiative on Capitol Hill.

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House Heads for Thursday Vote on ObamaCare Repeal

The House will vote on the GOP's ObamaCare repeal and replace plan Thursday after nearly seven years of trying to take down the healthcare law.

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Heads Up, Pharma. Trump’s Pushing GOP to Put “Competitive Bidding” on Drugs in Healthcare Bill

How would a “competitive bidding process” for drugs work? We may soon find out, if President Donald Trump gets his way with the Republican healthcare bill.

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Conservative House Republicans Say They Have Enough Votes to Stop Health Care Bill

Conservative House Republicans said Monday night that they have enough votes to block the GOP’s legislation to dismantle the Affordable Care Act, as House leaders proposed changes to the bill in a late effort to draw support.

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Understanding The Hidden Villain of Big Pharma: Pharmacy Benefit Managers

In the past few months, four bills have been introduced in Congress calling for transparency in prescription drug pricing. These bills—HR 1038, HR 1316, S.3308 and, earlier this week, one called C-THRU—largely concern pharmacy benefit managers (PBMs), a heretofore largely unrecognized component of the pharmaceutical industry.

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Marathon, Under Heavy Fire for Emflaza Pricing, Makes Surprise Deal to Sell Drug for $140M-Plus

Marathon Pharmaceuticals is in plenty of hot water after its brazen $89,000 pricing on the old-turned-new Duchenne muscular dystrophy drug Emflaza—a decades-old product available overseas for $1,000 per year. Now, it’s scored a quick payoff by selling the med to PTC Therapeutics in a deal potentially worth more than $190 million.

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Senate GOP Holdouts Split Into Rival Camps On Obamacare Overhaul

The House is racing to find enough votes for its health-care bill this week, but even if it passes, prospects in the Senate have only darkened.

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