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 House of Representatives unanimously voted to pass a bill Monday that extends the Medicare hospital at home program for five years. Hospital at home providers have been mired in uncertainty for years. Though Congress has repeatedly extended hospital at home flexibilities, it often only does so for a handful of months at a time. ...
The president injected more uncertainty last week, saying he doesn’t want to extend key insurance subsidies but understands it might be necessary.
The Trump administration is proposing significant changes to the metrics used to the calculate the Medicare Advantage star ratings. As part of the Contract Year 2027 MA and Part D proposed rule, the Centers for Medicare & Medicaid Services has pitched that the Excellent Health Outcomes for All award, known previously as the Health Equity ...
Eliza Brader worries she soon will need to prove she’s working to continue receiving Medicaid health coverage. She doesn’t think she should have to. The 27-year-old resident of Bloomington, Indiana, has a pacemaker and a painful joint disease. She also has fused vertebrae in her neck from a spinal injury, preventing her from turning her ...
Employers expect to see health benefits rise by 6.7% in 2026, reaching more than $18,500 per employee on average, according to a new report. Analysts at Mercer estimate that health costs in 2025 reached an average of $17,496 for each employee, growth of 6%. That’s a rate that outpaced inflation and wage growth, according to the report. ...
Sen. Bill Cassidy (R-La.) on Thursday said the Centers for Disease Control and Prevention (CDC) removing language from its website refuting the theory that vaccines are linked to autism was “deeply troubling.” Late on Wednesday, the CDC walked back its long-held position that vaccines do not cause autism. A CDC web page that previously stated “there is no link” ...
Optum Rx will reduce reauthorizations on 40 additional medications Jan. 1, surpassing initial goals set out earlier this year. The pharmacy benefit management arm of UnitedHealth Group first revealed earlier this year that it was aiming to reduce reauthorizations, a specific model for prior authorization, by up to 25%. The new additions bring the total ...
Insurers and drug companies facing dire threats to their bottom lines this year from President Donald Trump and Republicans in Congress had to make a choice: Stand and fight, or go to ground and cut some deals. Insurers fought in a bid to kill the threat; drugmakers cut deals to mitigate the damage. The early ...
While the FDA is streamlining regulation of copycat versions of the expensive drugs that millions take for arthritis, cancer, and other diseases, the U.S. patent office is making it harder for the cheaper medicines to get on the market, industry officials say. These officials were thrilled Oct. 29 when FDA Commissioner Marty Makary announced the ...
A US congressional commission is ringing alarm bells about China's growing dominance over America's drug supply, saying it is putting the country's health in the hands of an adversarial nation.