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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.

Health Insurance Gains Due to Obama’s Law, Not Economy

There's growing evidence that most of the dramatic gain in the number of Americans with health care coverage is due to President Barack Obama's law, and not the gradual recovery of the nation's economy.

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A Court Case That Could Hurt Obamacare’s Health

Just when you thought Obamacare was past legal challenges.

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Big Pharma Dumps Big Money Into Fight Against Prescription Drug Measure

Pharmaceutical companies continue to pour cash into their campaign to defeat a California ballot measure that would limit prescription drug prices, a new campaign finance analysis shows.

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No Clear Path to Government-Lowered Drug Prices

Most Americans support it. Virtually all other developed countries already do it. And the two leading presidential candidates on both sides of the aisle agree: the federal government should lower drug prices.

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Battle Heating Up Over ‘Surprise” Medical Bills

Have you ever gone in for a medical procedure you knew was covered by your health plan, only to be hit weeks later by a large, unexpected bill from a doctor whose name you didn’t even recognize?

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Anthem Sues Express Scripts Over Prescription Drug Pricing

Health insurance company Anthem is suing Express Scripts, the largest prescription drug benefit provider in the U.S., for allegedly charging too much for drugs.

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Walgreens, UnitedHealth Form Pharmacy Partnership

Two of the largest players in the U.S. pharmaceutical supply-chain, Walgreens Boots Alliance Inc. and UnitedHealth Group Inc.’s OptumRx, formed a partnership aimed at helping them capture a greater share of the prescription drug market.

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Secret Deals May Mean Consumers Pay More For Drugs

Secret deals often prompt drug benefit companies to cover brand-name prescriptions when equally effective generic or even over-the-counter medications are available, several drug pricing experts say.

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California Individual Marketplace May Require Insurers To Pay Agent Commissions

California’s health exchange may require its health plans to pay sales commissions to insurance agents to keep insurers from shunning the sickest and costliest patients.

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New Phase of CMS Audits to Include BAA’s: Brokers Need to Watch for Emailed Notices

As a part of its continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the HHS Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates.

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