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.
Millions of Americans have been signing up for health insurance at their companies in recent weeks. But for some full-time workers, particularly in certain industries like construction, job-based coverage isn’t an option for them. This divide was even more evident as the job market roared back to life in 2021 after steep losses early in the Covid-19 pandemic. Though the number ...
For supporters of congressional proposals to improve the U.S. retirement system, it’s about to be a nail-biting few weeks. Lawmakers are heading back to Washington next week to finish out the so-called lame-duck session — the legislative period between the midterm elections and the new Congress, which starts Jan. 3. While no specific agenda has ...
New data from the insurance industry estimate more than 9 million healthcare claims were subject to surprise billing protections, as a legal battle over how to implement such protections continues. Insurer industry groups AHIP and the Blue Cross Blue Shield Association (BCBSA) released a survey Thursday detailing the impact of the No Surprises Act (PDF)—which banned surprise ...
The merger, which is expected to close in the first quarter of next year, will create one of the biggest independent doctor groups in the US providing primary care, specialty care and urgent care.
A biologic therapy that delays the onset of type 1 diabetes received approval from the US Food and Drug Administration on Thursday. It is the first therapy approved for prevention of type 1 diabetes. The monoclonal antibody teplizumab, which will be marketed under the brand name Tzield, from ProventionBio and Sanofi is given through intravenous infusion. The ...
Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which examined billings from 2011 through 2013 and are the most recent reviews completed, were obtained ...
The Affordable Care Act (ACA) requires medical health insurers to offer a one-month Special Open Enrollment Window (SOEW), when eligible Small Group employers can enroll in medical coverage without having to meet standard employer-contribution and/or employee-participation ratios.
The United States will keep in place the public health emergency status of the COVID-19 pandemic, allowing millions of Americans to still receive free tests, vaccines and treatments, two Biden administration officials said on Friday.
Congress approved in August a $35 cap on what seniors will pay for insulin as part of the Inflation Reduction Act, along with free vaccines and other Medicare improvements. But the change came too late to add to the Medicare plan finder, the online tool that helps beneficiaries sort through dozens of drug and medical plans for the best bargain.
As Congress returns this week from a nearly monthlong recess, a collection of hospital groups is making sure resolution of a looming 4% cut to Medicare payments doesn’t slip through the cracks. The groups, led by the American Hospital Association and the Federation of American Hospitals, wrote to congressional leadership Monday calling for a waiver ...