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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.

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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Covered California 2017 Rate Hikes Will Hit State’s Central Coast Hardest

Last fall, a bladder condition forced Carmen Anguiano to leave her job at a packing shed in Salinas, a farming community off California’s Central Coast.

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Obamacare Is Helping More Poor Patients Get To The Doctor Even As Political Battles Continue

Even as the Affordable Care Act remains a political flash point, new research shows it is dramatically improving poor patients’ access to medical care in states that have used the law to expand their Medicaid safety net.

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Big Companies Expect Moderate Increases In 2017 Employee Health Care Costs

Big employers expect health costs to continue rising by about 6 percent in 2017, a moderate increase compared with historical trends that nevertheless far outpaces growth in the economy, two new surveys show.

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Medicare’s Readmission Penalties Hit New High

The federal government’s readmission penalties on hospitals will reach a new high as Medicare withholds more than half a billion dollars in payments over the next year, records released Tuesday show.

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