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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.

Health Net Being Acquired in $6.8 Billion Deal

Los Angeles-based managed care provider Health Net is being acquired by Centene Corp. in a deal valued at $6.8 billion. The deal could mean job losses at Health Net offices in Rancho Cordova, where more than 2,400 of the Woodland Hills-based health insurer's employees work.

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High Court’s Decision On Same Sex Marriage Expected To Boost Health Coverage Among Gay Couples

The right to marry in any state won’t be the only gain for gay couples from last week’s Supreme Court ruling. The decision will probably boost health insurance among gay couples as same-sex spouses get access to employer plans, say analysts and benefits consultants. How much is unclear, but “it’s going to increase coverage” in ...

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GOP Weighs Response to Supreme Court’s Federal Subsidies Ruling

After the Supreme Court on Thursday ruled to uphold Affordable Care Act subsidies to help U.S. residents purchase coverage through the federal exchange, the GOP could turn to budget reconciliation as part of its efforts to repeal the law, National Journalreports (Scott/Johnson, National Journal, 6/25). Background The subsidies were challenged in the case King v. ...

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Burwell Says Payment Policies Next Push In Obamacare Implementation

U.S. Health and Human Services Secretary Sylvia Burwell said on Thursday the Obama administration will focus on improving quality over quantity in the nation’s healthcare system in the implementation of the Affordable Care Act. The Supreme Court ruled earlier on Thursday to uphold the nationwide availability of tax subsidies that are crucial to President Barack ...

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Study Finds Almost Half of Health Law Plans Offer Very Limited Physician Networks

If the physician networks for plans sold on the health law’s online insurance exchanges were T-shirts, more than 40 percent would be size X-small or small. That’s the takeaway from a new study that analyzed nearly 400 physician networks in silver-level plans sold around the country  in 2014. The study labeled 11 percent of plans ...

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Top Obamacare Official Looks Ahead After Supreme Court Ruling

The U.S. official overseeing Obamacare said on Friday she has not seen any indication that states will back away from running their own health insurance marketplaces now that the Supreme Court has validated the federal insurance exchange. Sylvia Burwell, secretary of Health and Human Services, also said she expected enrollment in both the state and ...

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Medicare Slow To Adopt Telemedicine Due To Cost Concerns

Donna Miles didn’t feel like getting dressed and driving to her physician’s office or to a retailer’s health clinic near her Cincinnati home. For several days, she had thought she had thrush, a mouth infection that made her tongue sore and discolored with raised white spots. When Miles, 68, awoke on a wintry February morning ...

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When Turning 65, Consumers With Marketplace Plans Need To Be Vigilant In Choosing Health Coverage

Before the Affordable Care Act, older adults who couldn’t afford to buy their own health insurance would count the days until their 65th birthday, when Medicare would kick in. Now, 10,000 Americans hit that milestone every day, but for some who have coverage through the ACA’s insurance marketplaces, Medicare may not be the obvious next ...

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House Votes to Repeal Medicare Cost-Control Panel in ObamaCare

The House voted Tuesday to abolish a cost-cutting board under ObamaCare that has drawn criticism from members of both parties. Lawmakers voted 244-154 to abolish what is known as the Independent Payment Advisory Board (IPAB). The board is tasked with coming up with Medicare cuts if spending rises above a certain threshold, but has been criticized as ...

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Having Survived Court Ruling, Insurance Markets Still Face Economic Threats

Despite having survived a challenge in the U.S. Supreme Court, the federal government’s health insurance markets face weighty struggles as they try to keep prices under control, entice more consumers and encourage quality medical care. The government’s insurance markets – as well as more than a dozen run by states — have been operating for ...

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