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.
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 ...
The Silver State Health Insurance Exchange will not operate brick-and-mortar enrollment stores during this year’s sign-up period for government-subsidized health insurance. “It wasn’t fiscally prudent to walk in that direction,” Bruce Gilbert, executive director of the exchange, told board members at a meeting Thursday. Last year, the exchange opened two enrollment stores — one in ...
Two proposed mergers involving four of the nation’s biggest health insurers could reduce competition in an important industry. That’s why federal and state regulators need to closely study these deals and, if necessary, force the companies to sell some parts of their businesses. Earlier this summer, Anthem agreed to acquire Cigna for $48 billion, and Aetna ...
During this fall’s open enrollment period, workers who get health insurance through their employers may not see huge premium increases or significant hikes to deductibles or other out-of-pocket costs. But there may be less obvious changes that could make a notable difference in coverage or costs, benefits consultants say. Employers again are sharply focused on ...
Why did hospitals binge-buy doctor practices in recent years? To improve care coordination, lower costs and upgrade patient experiences, say hospitals. To raise costs, gain pricing power and steer patient referrals, say skeptics. Researchers at Stanford University tested those opposing arguments by comparing referral patterns between independent doctors and those working for hospitals. Ownership by ...
New government procedures have caused more than 400,000 immigrants to lose healthcare coverage they received under Obamacare this year, according to the Associated Press. The change in procedure shortens the timeframe during which foreign-born citizens can resolve eligibility issues, which has caused 423,000 people to lose their state-sponsored benefits. The healthcare law provides a 95-day ...
California had the most health insurance exchange enrollees of any state, with about 1.4 million enrollees as of June 30, according to new federal data, The Hill reports (Sullivan, The Hill, 9/8). Details of Exchange Enrollees Overall, the data show about 9.9 million U.S. residents had selected and paid for health coverage through the federal ...
The White House isn’t likely to wait long to challenge Wednesday’s ruling allowing House Republicans to sue the Obama administration for spending federal funds on the Affordable Care Act‘s cost-sharing assistance. The administration is expected to seek what’s called an interlocutory appeal, which would allow a higher court to consider the issue of whether ...