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 cracks in Medicaid that some experts feared eligible beneficiaries could slip through during the disenrollment process appear to forming, according to a new KFF survey. Many people eligible for Medicaid have not gone through the reenrollment process before. Many others simply aren’t aware that they’re eligible, according to KFF’s review of early data from 11 states. These ...
Biosimilars were supposed to be the catalyst for lower biologics prices, but in the case of insulin products, the leadership now seems to be coming from Medicare and the three dominant insulin producers: Eli Lilly, Novo Nordisk and Sanofi. Following a provision in the Inflation Reduction Act of 2022 that limited the monthly out-of-pocket cost ...
The U.S. Medicare health plan said on Thursday it would limit reimbursement for Eisai Co Ltd (4523.T) and Biogen Inc’s (BIIB.O) Alzheimer’s drug Leqembi to patients whose doctors participate in a health agency database should the drug win full approval, a move advocates say will hinder its use. The decision marks the first time that Medicare has required data-collection ...
There are concerns about the deal to raise the debt ceiling struck over Memorial Day weekend. One hang-up some conservatives have is the insufficient amount of provisions stipulating that individuals must engage in employment, job training, or community service to qualify for certain government-assistance programs.
Democratic lawmakers say they agreed to fine Californians without health insurance on the condition the state use that money to lower costs for residents purchasing coverage on the state exchange. They say Gov. Gavin Newsom has reneged on the deal.
The bill would require PBMs to meet new transparency requirements and would ban spread pricing in Medicaid. The (PATIENT) Act mandates that PBMs compile annual reports for employers with a slew of key information, including their drug spending, out-of-pocket costs, rebates, formulary placement and acquisition costs.
Health savings accounts (HSAs) offer a tax-advantaged way to save money to pay for certain medical expenses. Your HSA contributions are tax-deductible, so they potentially help reduce your taxable income. But contributions to your health savings account are limited each year by the IRS,
Four in 10 patients perceive implicit bias in their physicians, according to a MITRE-Harris survey on the patient experience. In addition to patients being extra sensitive to provider bias, the use of AI tools and machine learning models also have been shown to skew toward racial bias. On a related note, a recent study found 60% of Americans ...
Democrats beat back efforts to attach Medicaid work requirements to a debt limit deal, but the agreement reached over the weekend will claw back about $30 billion of unspent COVID relief funds and likely bring more budget austerity to federal health agencies. Why it matters: GOP negotiators had increasingly insisted that Medicaid work requirements needed to ...
As Washington struggles to reach a debt ceiling deal with little more than a week until potential default, a key hangup in the negotiations is turning out to be -- "work requirements."