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.
By sheer number of covered lives, Kaiser Permanente has been California’s largest health insurer for decades. But if Anthem gets its way — no longer. The Indianapolis-based insurer is currently the second-largest health insurer in the Golden State, and one of the three largest health insurers in the nation. Its planned mega-merger with Cigna is ...
About 9.9 million people have signed up and paid for health insurance under President Barack Obama’s health care law, the administration said Tuesday, a slight dip from a previous count but on track toward the administration’s year-end goal of 9.1 million. The U.S. Department of Health and Human Services said that 84 percent of those, ...
As the open enrollment season for employer-sponsored health insurance gets underway this fall, experts say there’s one group that should definitely consider changing plans: people who have coverage through their former employer under the federal law known as COBRA. COBRA allows people who leave their jobs to keep their job-based group coverage for 18 months, ...
The White House is calling for a “more aggressive strategy” to reduce improper payments made by Medicare and the Affordable Care Act (ACA), according to a letter made public to the Department of Health and Human Services (HHS). The Center for Public Integrity obtained the February letter — written by Office of Management and Budget Director Shaun ...
BOSTON — President Obama rallied union workers here Monday, unveiling a new executive order that will require federal contractors to offer employees up to seven days of paid sick leave, a move he sought to contrast with Republican economic policies. Obama announced the new directive, which the White House said could benefit more than 300,000 ...
On Tuesday, the Center for Medicare and Medicaid Innovation at CMS announced a new pilot program that will allow Medicare Advantage insurers to lower beneficiaries’ out-of-pocket costs as a way to encourage them to use high-quality services and potentially reduce overall costs in the long term, Modern Healthcare reports. The five-year program begins Jan. 1, ...
A new test within the Medicare Advantage program will lower out-of-pocket costs for chronically ill patients who seek high-value services and providers. Supporters hope the project will lead to changes in federal law and become a template for all health plans with sizable cost-sharing, which have become the standard offering from employers and insurers. But ...
WASHINGTON — Doctors and hospitals are stepping up their criticism of proposed health insurance company mergers. In a new study to be released on Tuesday, the American Medical Association says that most insurance markets in the United States are dominated by a few companies and would become even more concentrated with a plan by Anthem ...
WASHINGTON — The CEO who pulled off the first major insurance company merger agreement of the summer also achieved what many executives might think impossible: He raised his company’s minimum wage, announced plans to up its contribution to workers’ health care and watched the stock soar by nearly 30% since January. But Aetna’s Mark Bertolini is used ...
Sutter Health Plus, the HMO health plan of Sacramento-based Sutter Health, has joined CaliforniaChoice and will offer 12 small group plan designs later this year. Orange-based CaliforniaChoice is a private exchange for employer groups and employees. Sutter recently received approval to join CaliforniaChoice from the state Department of Managed Health Care. Sutter said brokers and ...