ACA Category Banner


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.

Lawsuit Against Insurer Claims Retaliation Against Docs for Out-of-Network Referrals

California’s highest court has revived a high-profile lawsuit that could have a major impact on whether insurers can punish physicians who refer patients to out-of-network providers. The case, which has bounced around courts in the Golden State since 2012, pits the nearly 50,000-member California Medical Association (CMA) against Aetna, one of the nation’s largest health ...

Read More

Biden Administration Asks Employers To Give More Help To Workers Who Lose Medicaid

The Biden administration on Thursday asked employers to give workers who lose Medicaid coverage more time to sign up for health insurance through their jobs. Medicaid is the state- and federally funded program that covers health care costs for people with low incomes. States have resumed checks for Medicaid eligibility this year after pausing the practice during ...

Read More

The Biden Administration Proposes New Rules To Push Insurers To Boost Mental Health Coverage

The new regulations, which still need to go through a public comment period, would require insurers to study whether their customers have equal access to medical and mental health benefits and to take remedial action, if necessary.

Read More

Employers, The Supreme Court Just Made Your Job Harder

The Supreme Court just issued two decisions that will affect the legal landscape for employers for years to come. Although the Court’s rulings on affirmative action and religious accommodation will have different short-term impacts, it is highly likely that each decision will give rise to new legal challenges that could significantly alter how employers hire and manage their workers.

Read More

US Government Tells Vaccine Makers To Price Updated COVID Shots Reasonably

COVID vaccine makers should price their updated shots for the fall at a reasonable rate that would reflect the benefits they received through government investments, the U.S. Department of Health and Human Services (HHS) said on Thursday. The U.S. government will also launch a $1 billion “Bridge Access Program” for this fall, to help those ...

Read More

Department Of Labor Announces Rule Expanding Submission Requirements For Injury, Illness Data Provided By Employers In High-Hazard Industries

The U.S. Department of Labor today announced a final rule that will require certain employers in designated high-hazard industries to electronically submit injury and illness information – that they are already required to keep – to the department’s Occupational Safety and Health Administration. The final rule takes effect on Jan. 1, 2024, and now includes the ...

Read More

Two Years After Enactment, Industry Still Sorting Out Implications Of Many CAA Provisions

The Consolidated Appropriations Act of 2021 created one of the largest transformations in employee health benefits regulation since 1943. It brought with it new transparency requirements, anti-gag clause requirements, broker compensation disclosure rules and more. Two years later, it remains a work in progress.

Read More

Supreme Court Buoys Religious Employees Who Seek Accommodations At Work

The U.S. Supreme Court on Thursday bolstered the ability of employees to obtain accommodations at work for their religious practices, reviving a lawsuit by an evangelical Christian former mail carrier accusing the Postal Service of discrimination after being disciplined for refusing to show up for work on Sundays. The 9-0 ruling threw out a lower ...

Read More

New Law: Pregnant Workers May Get Longer Breaks, More Time Off And Other Accommodations

Millions of pregnant and postpartum workers across the country could be legally entitled to longer breaks, shorter hours and time off for medical appointments and recovery from childbirth beginning Tuesday, when the Pregnant Workers Fairness Act takes effect. The new law mandates that employers with at least 15 employees provide “reasonable accommodations” to workers who ...

Read More

Biden Administration Targets Unexpected Health Costs

The Biden White House announced a trio of steps aimed at protecting patients from unexpected health care costs on Friday, with new actions surrounding short-term health plans, surprise medical bills and medical debt. The Department of Health and Human Services’ proposed rule to limit the scope of short-term health plans would unwind a key Trump ...

Read More