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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.

Nevada Considers Transitioning to Healthcare.gov

The clock is ticking for various state legislatures that are pondering a change in the way their residents enroll in public health insurance exchanges ahead of the widely anticipated June ruling in King v. Burwell on whether federal subsidies will be scrapped in 34 states that rely on Healthcare.gov for signups. One such example is a joint ...

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New Preventive Health Services Approved For No-Cost Coverage

The list continued to grow of preventive services that people are entitled to receive without paying anything out of pocket. In 2014, the U.S. Preventive Services Task Force recommended two new services and tweaked a handful of others that had previously been recommended. Under the health law, preventive care that receives an “A” or “B” ...

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Bill Adds Pregnancy as Insurance-Eligible Life Event

California lawmakers are advancing legislation to add pregnancy to the list of so-called ‘life-qualifying events’ allowing people to buy health insurance outside the regular open enrollment period. U.S. Sens. Barbara Boxer and Dianne Feinstein of California have urged the state to adopt the measure, and advocates are pressuring federal health authorities to do the same. ...

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Health Chief: ObamaCare Premium Hikes Will Drop

Secretary of Health and Human Services Sylvia Mathews Burwell argued Thursday that premium hikes floated by health insurance companies this week will likely end up being lower once they are finalized. Republicans have seized on the higher rates to attack the healthcare law. Tennessee’s biggest insurer has proposed an increase of 36 percent for some ...

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Stakeholders Say ACO Final Rule Fails To Address Some Concerns

Some health care organizations might opt to leave the accountable care organization program because CMS did not address some of their concerns in its latest rules update, Modern Healthcare reports (Dickson, Modern Healthcare, 6/5). New Final Rule Details CMS on Thursday issued a final rule for the Medicare Shared Savings Program that seeks to keep ...

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Blue Shield’s Proposed Acquisition of Care1st Faces Tough Scrutiny

A top California regulator vowed a “deep dive” into a $1.2-billion acquisition proposed by Blue Shield of California amid criticism that the nonprofit insurer is shortchanging the public. Shelley Rouillard, director of the state Department of Managed Health Care, signaled tough scrutiny ahead for Blue Shield’s proposed purchase of Medicaid insurer Care1st Health Plan at ...

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If Supreme Court Rules Against Obamacare, Few States Are Ready For The Fallout

Millions of Americans could soon lose health insurance when the Supreme Court decides the latest challenge to the Affordable Care Act this month, but states have made few concrete plans to deal with the potential fallout, and they may get little help from Washington, President Obama warned Monday. “If somebody does something that doesn’t make ...

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Obama Is Optimistic Justices Will Let Health Care Law Stand

WASHINGTON — A decision by the Supreme Court to strike down health care subsidies in federally run marketplaces would be a “contorted reading” of the Affordable Care Act that would disrupt coverage for millions of people, President Obama said on Monday. But at a news conference at the end of a two-day trip to Germany, ...

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California Legislative Update – Big Day for Health Care Bill Passage

Floor sessions on Tuesday in the state Senate and Assembly were fast-paced affairs. The deadline to pass bills out of their house of origin is June 5 so the legislation queue on Tuesday was pretty long and resulted in a rapid-fire pace. The Senate passed a high-profile measure to expand coverage to some undocumented immigrants. A ...

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Patient Finds Shopping for Low-Priced CT Scan Doesn’t Pay Off

Douglas White knew high-deductible insurance is supposed to make patients feel the pain of medical prices and turn them into smart shoppers. So he shopped. He called around for price quotes on the CT scan his doctor ordered. After all, his plan’s $2,000 deductible meant paying the full cost out of pocket. Using information from ...

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