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.
The Federal Trade Commission took action Friday against the nation’s three largest pharmacy benefit managers, accusing the companies of artificially inflating insulin list prices that resulted in patients paying more for the medications. The agency alleges that CVS Health’s Caremark Rx, Cigna’s Express Scripts and UnitedHealth Group’s Optum Rx and their affiliated group purchasing organizations ...
Health care is the most frequent target for ransomware attacks: In 2023, the FBI says, 249 of them targeted health institutions — the most of any sector. And health executives, lawyers, and those in the halls of Congress are worried that the federal government’s response is underpowered, underfunded, and overly focused on protecting hospitals.
Republicans voted Wednesday morning in favor of a resolution disapproving of a Biden administration rule limiting access to association health plans. With a vote of 23-12, House Committee on Education and the Workforce members offered support for association health plans, a provision that is supported by some organizations such as the National Federation of Independent ...
California Gov. Gavin Newsom will soon decide whether the most populous U.S. state will join 25 others in regulating the middlemen known as pharmacy benefit managers, or PBMs, whom many policymakers blame for the soaring cost of prescription drugs. PBMs have been under fire for years for alleged profiteering and anticompetitive conduct, but efforts to ...
The Biden administration announced a final rule on Monday meant to expand access and lower costs for care for mental health and substance use disorders. Most provisions in the rule will apply to group health plans and health insurance issuers for plan years starting January 1 or after. Under this rule, mental health and substance use ...
California lawmakers are debating whether to go where Congress won't and pass legislation that would give the state the ability to block private equity acquisitions of health care facilities or providers.
Federal regulators have blocked two private sector enrollment websites from accessing consumer information through the federal Obamacare marketplace, citing “anomalous activity.” The unusual step comes as the Centers for Medicare & Medicaid Services is under the gun to curb unauthorized enrollment and switching of Affordable Care Act plans by rogue agents. The agency received more ...
Vice President Kamala Harris’ selection of Minnesota Gov. Tim Walz as her running mate is making health care a front-burner issue in the final sprint to the November presidential election. Walz, a 60-year-old former high school teacher and football coach, has a record of supporting left-leaning health care initiatives during his two terms as governor ...
A bill pending in California’s legislature to ratchet up oversight of private equity investments in health care is receiving enthusiastic backing from consumer advocates, labor unions, and the California Medical Association, but drawing heavy fire from hospitals concerned about losing a potential funding source. The legislation, sponsored by Attorney General Rob Bonta, would require private equity groups ...
Hospitals must promptly report to the Los Angeles County Department of Public Health every time they try to collect medical debt from patients, under an ordinance backed Tuesday by county supervisors. The ordinance, which requires a second vote to be adopted, requires hospitals to tell the county within a month or two of initiating debt ...