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 Biden administration is proposing a 2.8% decrease to physician payments in its newly released pay proposal for physicians, drawing near-immediate protest from the industry. Unveiled Wednesday afternoon, the calendar year 2025 Medicare Physician Fee Schedule proposed rule outlines new policies focused on primary care, preserved telehealth flexibilities and a strengthened Medicare Shared Savings Program ...
A proposed rule that would require the nation's most critical industries to more quickly report cyberattacks is raising the ire of the health care industry, which claims the new directives could actually hinder its response in a crisis.
Private insurance firms running Medicare Advantage programs have been overcharging the federal government billions of dollars by making patients look sicker than they really are, according to a report in The Wall Street Journal on Monday.
The Internal Revenue Service (IRS) has recently been ramping up its enforcement of employer requirements related to the Affordable Care Act (ACA), and the penalties for non-compliance can sometimes be severe. Employers with at least 50 full-time employees, considered an Applicable Large Employer (ALE), are subject to Employer Shared Responsibility Provisions of the ACA. These provisions require organizations considered ...
The US Supreme Court has again overturned longstanding precedent, this time getting rid of a 40-year- old standard for decision making that required federal courts to defer to reasonable agency decisions where federal law is silent or unclear.
Recent Supreme Court decisions curbing the power of federal agencies will hobble government efforts to protect public health, legal experts warn. The rulings will make it harder for some federal agencies to bring enforcement actions.
A report from a conservative think tank found that as many as 5 million people are wrongfully receiving Affordable Care Act insurance subsidies, prompting House Republican leaders to call for an investigation into possible enrollment fraud.
A provision of Biden’s Inflation Reduction Act requires drugmakers to pay rebates to Medicare if they hike the price of a medication faster than the rate of inflation.
After the Supreme Court struck down a controversial bankruptcy plan from Purdue Pharma, the maker of OxyContin, those who sued the drug company were left uncertain about when promised funds would be available to combat addiction and other damage from the ongoing drug epidemic. The ruling upended a carefully-crafted settlement worth roughly $8 billion, and involving the Sackler family, ...
An appeals court affirmed a lower court's ruling that HHS could not force Braidwood and other firms who challenged the ACA mandate to cover PrEP drugs for HIV, however, the nationwide ACA coverage mandate is still in effect.