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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.

Capping Insurance Premiums Will Not Solve Rising Health Care Costs

Five years ago, if you didn't receive health coverage through your employer or couldn't qualify for Medi-Cal, finding affordable insurance could be difficult at best, and completely out of reach at worst. Many young, healthy people opted out of insurance altogether, and those most in need of medical care found it hard to get coverage at all.

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Drug Price Transparency Bill Clears Key Hurdle in California Legislature

Controversial California legislation requiring drug companies to justify treatment costs and price hikes jumped one more hurdle Thursday, just a few weeks before the end of the legislative session.

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WSJ Opinion: ACA Sicker Shock and the Election

Hillary Clinton admits she’s running to extend the Obama legacy, and so far she’s had a free ride in defending it. She hasn’t even had to explain the increasingly obvious failures of ObamaCare to deliver the affordable insurance that Democrats promised.

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Covered California Losses Cited by Blue Shield for Labor Day Workload Adjustment

Blue Shield of California is shutting down for the four days after Labor Day to reduce its payroll-related liabilities, citing losses in California's Covered California Obamacare exchange and other commercial and individual lines of business.

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Aetna to Pull Back From Public Health Care Exchanges

In a blow to President Obama’s health care law, Aetna, one of the nation’s major insurers, said Monday that it would sharply reduce its participation in the law’s public marketplaces next year.

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When It’s Time To Split Up The Family

All five members of the Wadstein family have Covered California’s most comprehensive — and expensive — level of health insurance, even though the two youngest children are the only ones who need that kind of plan.

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Syncing Up Drug Refills: A Way To Get Patients To Take Their Medicine

You have your red pill and your green pill. There’s the one you take at breakfast, the one you take before bed and the one you have to take six hours after eating.

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New Medicare Law to Notify Patients of Loophole in Nursing Home Coverage

In November, after a bad fall, 85-year-old Elizabeth Cannon was taken to a hospital outside Philadelphia for six and a half days of “observation,” followed by nearly five months at a nearby nursing home for rehabilitation and skilled nursing care. The cost: more than $40,000.

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Medicare Levies Higher Average Penalties on SoCal Hospitals for High Readmission Rates

The region's average penalty was just over one-half of 1 percent of total Medicare reimbursements; last year it was one-third of 1 percent. Still, that's lower than the national average, says Jordan Rau, a Kaiser Health News journalist who interpreted the annual Medicare data.

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Aetna Judge Hands Off Anthem Merger Case to Speed Trials

The judge overseeing two U.S. cases challenging mergers among four of the biggest health insurers gave up one, improving the odds for rulings on both tie-ups by the end of the year and reducing the chance they fall apart beforehand.

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