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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.

Employers Shifting More Medical Costs to Workers

Employers are leaving a bigger chunk of the bill for care to workers who use their health insurance, and benefits experts see few signs of this trend slowing. Most companies now offer health coverage that requires employees to pay an annual deductible before insurance kicks in, and the size of that deductible has soared in ...

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GOP Targets ObamaCare Taxes in Fast-Track Process

Republicans will seek to repeal a range of ObamaCare taxes as well as the healthcare law’s mandates to buy insurance through the fast-track process known as reconciliation. President Obama is sure to veto the measures, but reconciliation will allow them to at least reach his desk, bypassing an expected Senate Democratic filibuster. The process is ...

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Two Halves of California Have Wide Gap in Health Costs

When it comes to health care costs, it’s clear: Where you live matters. And in California, the gap is especially sharp between the north and south. Take, for instance, common procedures like a cesarean section or a total knee replacement. The total average price tag for a typical C-section in the four-county Sacramento area is ...

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Healthcare Costs Rise Again, and the Burden Continues to Shift to Workers

American workers saw their out-of-pocket medical costs jump again this year, as the average deductible for an employer-provided health plan surged nearly 9% in 2015 to more than $1,000, a major new survey of employers shows. The annual increase, though lower than in previous years’, far outpaced wage growth and overall inflation and marked the continuation ...

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Clinton Adds Details to Plans on Prescription Drug Costs

Hillary Rodham Clinton is outlining a sweeping plan to hold down the rising cost of prescription drugs and target drug companies that flood the airwaves with ads. The Democratic presidential candidate says at a forum in Iowa that she wants to protect consumers while promoting innovation and putting an end to profiteering in the pharmaceutical ...

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Prime Healthcare Sues Attorney General Over Hospital Sale

Prime Healthcare, which backed out of its proposed bid to buy six Daughters of Charity Health System hospitals, including two in the Southland, after disagreeing with conditions imposed on the sale sued the state’s attorney general Monday for allegedly abusing her constitutional powers. In the lawsuit filed in federal court in Los Angeles, Prime Healthcare ...

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Employer Family Health Premiums Rise 4 Percent to $17,545 in 2015, Extending a Decade-Long Trend of Relatively Moderate Increases

Menlo Park, Calif. – Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2015 Employer Health Benefits Surveyreleased today. Since 2005, premiums have grown an average of 5 percent each year, compared ...

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Community Health Centers Get Another $500M Boost Under ObamaCare

The Obama administration is injecting another half-billion dollars into community health centers across the country, which are facing growing demands under ObamaCare. The government-backed health centers, which have expanded massively under the Affordable Care Act, have been put into a new political context this summer as Republicans in Congress try to defund Planned Parenthood. Republicans ...

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Medicare Advantage Enrollment Up by 7.3%, Expected To Grow More

Enrollment in Medicare Advantage plans is up by 7.3% from this time last year, and more beneficiaries are expected to sign up when the program’s annual open enrollment period begins next month,Modern Healthcare reports. CMS data show that about 17.7 million people are enrolled in an MA plan, up from nearly 16.5 million individuals at ...

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CMS Says 2016 Average MA Premiums To Drop by 31 Cents

On Monday, CMS announced that the average monthly premium for Medicare Advantage plans in 2016 will drop by about 31 cents,Modern Healthcare reports (Herman, Modern Healthcare, 9/21). According to CMS, average MA premiums will likely decrease from an average of $32.91 this year to $32.60 next year (Young, CQ HealthBeat, 9/21). MA premiums are expected ...

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