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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.

Humana To Abandon Obamacare Patients In 1,200 U.S. Counties

Humana is the latest health insurer to significantly pull back its participation selling subsidized individual coverage under the Affordable Care Act, announcing plans to scale back next year to “no more than 156 counties” across 11 states.

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Anthem Asks for Separate, Speedy Trial in Bid to Save Deal for Cigna

Health insurer Anthem Inc, which is fighting the government to save its merger with rival Cigna Corp, asked a judge on Tuesday to decide on the deal by the end of the year and to split its case off from the government's challenge of a second merger of insurance companies.

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Aetna Backs Off Plans to Expand Its ACA Business

Aetna Inc. became the last of the five major national health insurers to project a loss on Affordable Care Act plans for 2016, underscoring concerns about the stability of the insurance marketplaces at the heart of the Obama administration’s signature health law.

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Controversial Rating System Gives Six Nevada Hospitals One Star

Five Southern Nevada hospitals were among six statewide that received only one star in a controversial five-star rating system unveiled Wednesday by the Centers for Medicare & Medicaid Services.

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Study Bodes Well For Biosimilars But Highlights Need For More Research

Research released Monday finds comparable safety and efficacy for one type of biosimilar drugs, complex medicines intended to be near-copies of some of the most costly prescription drugs on the market, but highlights the need for more information on the products.

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Many Well-Known Hospitals Fall Short of 5 Stars In Medicare’s New Ratings

The federal government released its first overall hospital quality rating on Wednesday, slapping average scores on some of California’s best-known medical centers while awarding top scores to unheralded ones.

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Long-Term Care Is An Immediate Problem – For The Government

Donna Nickerson spent her last working years as the activity and social services director at a Turlock, Calif., nursing home.

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Frustration Mounts Over ObamaCare Co-Op Failures

A new wave of failures among ObamaCare's nonprofit health insurers is disrupting coverage for thousands of enrollees and raising questions about whether regulators could have acted earlier to head off some of the problems.

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Senior Surprise: Getting Switched With Little Warning Into Medicare Advantage

Only days after Judy Hanttula came home from the hospital after surgery last November, her doctor’s office called with bad news: Records showed that instead of traditional Medicare, she had a private Medicare Advantage plan, and her doctor and hospital were not in its network.

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Big Pharma Is Jacking Up the Price of the ‘Antidote’ to the Overdose Crisis

President Barack Obama recently signed a law aimed at addressing the burgeoning opioid crisis in the US.

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