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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.

Three Changes Consumers Can Expect In Next Year’s Obamacare Coverage

Health insurance isn’t simple. Neither are government regulations. Put the two together and things can get confusing fast.

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High Deductibles Clash With Care Coordination And Primary Care

High deductibles add to consumers' financial stress and dissuade some patients from getting needed medical care.

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$1.2 Billion In Loans to ACA Health Insurance Co-Ops May Be A Loss, Report Warns

The failures of a dozen non­profit health insurance plans created by the Affordable Care Act could cost the government up to $1.2 billion, according to a harsh new congressional report that concludes federal officials ignored early warnings about the plans’ fragility and moved in too late as problems arose.

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Obama Health Law Missed 2015 Enrollment Target

Last year's final enrollment numbers under President Barack Obama's health care law fell just short of a target the administration had set, the government reported Friday.

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Medicare Plans Score Higher Ratings And Millions In Bonuses

Vantage Health Plan executives saw an opportunity when they realized few of their female Medicare members were being screened for osteoporosis after they broke bones.

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Death Spirals Loom for Health Insurers

Obamacare enrollment is already millions of people below original forecasts, and we could see two sorts of death spirals in the insurance exchanges of the Affordable Care Act because of premium inflexibility mandated by law and partisan unwillingness to make the necessary compromises to fix it.

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Obama Says Enrollment in Affordable Care Act Reaches 20 Million

President Obama said on Thursday that enrollment in health coverage under the Affordable Care Act had reached a new high, 20 million, and he called the law an overwhelming success in this city and around the nation despite Republicans’ implacable opposition.

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When Governments Mandate Transparency of R&D Costs, the Details are Important

There has been a new interest in expanding the transparency of pharmaceutical markets, in many areas, including information about the outlays on R&D for the development of specific drugs. The debate over transparency legislation, still pending but stalled in California (AB 463), raised public attention to this issue worldwide and has stimulated additional interest in transparency measures in various states (notably in Colorado) and among members of Congress and in foreign countries.

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Retail Clinics Add Convenience But Also Hike Costs, Study Finds

Retail clinics, long seen as an antidote to more expensive doctor offices and emergency rooms, may actually boost medical spending by leading consumers to get more care, a new study shows.

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ObamaCare’s ‘Ceiling’ for Sign-ups Could Be 14.7 Million

ObamaCare enrollment could have a “ceiling” of around 14.7 million sign-ups, according to a new analysis from the Kaiser Family Foundation.

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