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.
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.
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?
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.
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.
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.
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.
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.
Just when you thought Obamacare was past legal challenges.
Doctors have long disputed the accusation that the payments they receive from pharmaceutical companies have any relationship to how they prescribe drugs.
Kaiser Permanente is moving forward with its ambitious plan to open a medical school that's more in tune with new technologies and local communities.