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.
Members of Congress from both parties, as well as some employers, insurers and state insurance commissioners, are calling for changes in the Affordable Care Act to prevent premium increases that are expected to affect workers at many small and midsize companies next year. Lawmakers see the potential for a rare bipartisan agreement on the issue, ...
In a significant yardstick of how health care coverage has blanketed the country under the Affordable Care Act, California ranked among states recording the biggest drop – 4.7 percent – in uninsured residents from 2013 to 2014, according to U.S. Census Bureau data released Wednesday. The new data confirm California has seen “one of the ...
On Tuesday, CMS said it will enforce the Affordable Care Act’s cap on annual out-of-pocket health care spending for individuals, regardless of whether consumers have an individual or family health plan, Modern Healthcare reports. Background In February, CMS released a wide-ranging final rule for the health insurance exchanges that finalized several consumer and insurer protections. ...
Specialists in infectious disease are protesting a gigantic overnight increase in the price of a 62-year-old drug that is the standard of care for treating a life-threatening parasitic infection. The drug, called Daraprim, was acquired in August by Turing Pharmaceuticals, a start-up run by a former hedge fund manager. Turing immediately raised the price to ...
The forms that employers must use to fulfill annual information reporting requirements under the Affordable Care Act were released Sept. 17 by the Internal Revenue Service. Employers have to file the forms in the first quarter of 2016 to provide a month-by-month breakdown of health-care coverage offered during tax year 2015, and to list out ...
Roughly 17.7 million seniors and disabled Americans are enrolled in Medicare Advantage, and many more are expected to sign up for the private Medicare health plans when the annual enrollment period begins next month. The total Advantage population as of September 2015 is up 7.3% from the almost 16.5 million people who had Advantage coverage ...
Repealing ObamaCare’s individual mandate would save about $300 billion over the next decade while driving the nation’s uninsured rate back up to 2013 levels, according to new federal budget estimates. Government health departments would save about $311 billion over 10 years if Republicans successfully repealed the mandate, which requires nearly all adults to purchase healthcare ...
The Obama administration said Tuesday that 9.9 million people have ObamaCare coverage, a slight drop from the previous count of 10.2 million. The new data are for people who have paid their premiums as of June 30, marking a drop-off from the number enrolled through March 31. Both figures are down from the 11.7 million ...
The CMS is sticking to its guns on the maximum out-of-pocket limits for medical care, stating Tuesday that members within families shouldn’t have to pay more than individual consumers. The Affordable Care Act limits how much people have to pay out of pocket for deductibles, coinsurance and copayments. The maximum yearly amount is $6,850 for ...
Late last month, the Nevada Health Co-op became the third casualty among 23 insurance start-ups created under the federal health care law to inject competition for coverage in certain parts of the country. Set up as nonprofits with consumer-led boards, the co-ops were designed to provide affordable insurance coverage to individuals and small businesses. They ...