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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.

Are Indoor Holiday Parties Safe As COVID, Flu And RSV Spread? We Asked Three Experts

The past three years the holidays have been clouded with pandemic concerns. Now, with COVID, the flu and RSV circulating — what should folks look out for at gatherings? The Sacramento Bee service journalism team posed the same questions to three California hospitals. The following doctors provided emailed responses: * Dr. Matthew Eldridge, chief of ...

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More Than 7 Million Incorrect Diagnoses Made In US Emergency Rooms Every Year, Government Report Finds

A new study finds that nearly 6% of the estimated 130 million people who go to US emergency rooms every year are misdiagnosed, which translates to about 1 in 18 patients getting the wrong diagnosis. The report, published Thursday by the US Department of Health and Human Services’ Agency for Healthcare Research and Quality, reviewed nearly ...

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CMS Proposes New Medicare Advantage And Part D Reforms On Prior Authorization, Marketing

The Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule Wednesday outlining policies for MA and Part D plans for the 2024 coverage year and implementing drug price provisions in ...

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IRS' 2023 Contribution Limits For HSA, FSA, 401(K): What Plan Sponsors Need To Know

Following recent announcements by both the IRS and the Social Security Administration, we now know most of the dollar amounts that employers will need in order to administer their benefit plans for 2023.

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Biden Administration Proposes Crackdown On Scam Medicare Ads

The Biden administration on Wednesday proposed a ban on misleading ads for Medicare Advantage plans that have targeted older Americans and, in some cases, convinced them to sign up for plans that don’t cover their doctors or prescriptions.

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After Congress Extends Subsidies, Officials Urge Nevadans To Get Health Insurance

State officials are urging Nevadans to take advantage of low-cost health insurance plans available on the marketplace created through Obamacare, touting a multi-year extension of government subsidies approved over the summer through the Inflation Reduction Act.

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Out-Of-Pocket Health Costs Spiked In 2021

Americans’ out-of-pocket health spending rose 10.4% in 2021, a growth rate not seen since 1985 that was driven in part by demand for dental services, eyeglasses and medical supplies, according to Centers for Medicare and Medicaid Services’ annual National Health Expenditures report. The big picture: Overall health spending grew by only 2.7%, a much smaller rate than ...

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Health Insurance is Helping Cool Inflation. But ‘It’s Not a Very Good Reflection’ of What People Pay, Cautions Economist

In an environment of high inflation, health insurance costs are doing the opposite: They’ve begun to deflate, and are poised to continue dropping each month until fall 2023, economists predict. Health insurance prices fell by 4% in October and 4.3% in November, according to the consumer price index, a key measure of inflation. By comparison, the ...

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Annual Employer Compliance Responsibilities

Each year brings annual compliance responsibilities to employers regarding their health plans, federal Affordable Care Act (ACA) compliance, and COBRA responsibilities. It’s important for employers to be aware of – and adhere to – these responsibilities, supported by their health insurance brokers.

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Employers Estimate Health Benefits Costs Will Rise 5.4% Next Year

Analysts at Mercer polled more than 2,000 employers representing 124 million full-time and part-time employees and found that they expect benefits costs to increase by 5.4% next year. And they're expecting faster cost growth to continue in the near future, according to the survey.

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