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.
Mark Cuban, owner of Cost Plus Drugs and a longtime critic of the pharmaceutical industry, is speaking out in support of the congressional Break Up Big Medicine Act. “I don’t think people realize how much health care costs are driving big companies to fire and not hire,” he wrote in a social media post. “It ...
CVS Health subsidiary Aetna, Elevance Health and Humana must face a civil lawsuit alleging they paid kickbacks to online brokerages for Medicare Advantage enrollments, a federal court ruled Wednesday. A whistleblower initiated the case in 2021, which the U.S. District Court for the District of Massachusetts unsealed last year after the Justice Department intervened. According to the ...
House Republicans announced Monday that Congress will mount an investigation into “rampant hospice fraud,” alleging that potentially tens of millions in taxpayer funds may have been lost in improper payments to Southern California companies. The Republican-led House Oversight Committee, which has the authority to investigate, has sent a letter to California’s Democratic governor, Gavin Newsom, ...
A group operating out of a Friar Street office building in Van Nuys that advertises “virtual offices” incorporated 22 hospices and home care agencies in one year, including 15 hospices registered in one day to a single suite, according to an investigation by the Southern California News Group. The 15 hospices, all formed in “Suite 205” ...
As a result of the ruling, HHS has postponed a planned meeting of the Advisory Committee on Immunization Practices this week.
A proposal to remake the health insurance exchanges could open up a vast new market to emerging companies that sell health plans without provider networks. Cash-pay startups and reference-based pricing companies such as Sidecar Health and Imagine360 say they are ready to jump at the opportunity. The Centers for Medicare and Medicaid Services issued a proposed ...
Managers of Anthem Blue Cross think that in-network hospitals in California should use in-network physicians to treat health plan participants. The Elevance Health subsidiary announced earlier this week that it will impose a 10% payment penalty on some in-network hospitals and other health care facilities that bill patients for care provided by out-of-network doctors. “Participating facilities ...
For-profit acute and behavioral hospital operator Universal Health Services is acquiring virtual behavioral care provider Talkspace, the companies announced on Monday. The definitive agreement would see Talkspace acquired for $5.25 per share. That translates to an enterprise value of about $835 million, according to the announcement. The deal is expected to close in Q3. UHS ...
What Does Today’s Supreme Court Decision Striking Down Tariffs Mean For The Pharmaceutical Industry?
The Trump administration has other legal avenues to impose tariffs on pharmaceuticals despite today’s Supreme Court decision striking down many of the administration’s current tariffs. In a 6-3 decision, the court ruled that President Donald Trump did not have the authority to impose tariffs under a 1977 law, the International Emergency Economic Powers Act. But ...
Assemblymember Ash Kalra has tried a handful of times over the past few years to institute massive changes in the state's health care system.