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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.

ACA's Preventative Care Requirement Under Attack

Plaintiffs in an Affordable Care Act lawsuit are now asking a federal judge to toss all parts of the law requiring coverage of preventive health services.

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CMS Issues Medicare Broker Call Recording FAQs

As 2023 annual open enrollment begins, CMS has received questions regarding changes, including the requirement related to recording calls between beneficiaries and Third-Party Marketing Organizations (TPMOs) and the requirements related to the TPMO disclaimer.

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Plan Premiums To Soar Along With Health System Labor Increases

Employer-sponsored health plans will likely see premiums increase by an average of 6.5% in 2023. The main driver? A shortage of health care employees, notably nurses. This is forcing health systems to pay more to current employees and offer more to recruit hard-to-find professionals.

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IRA Means Increased Drug Prices For Commercial Plans: Ways To Prepare

The recently enacted Inflation Reduction Act (IRA) includes several provisions aimed at lowering prescription drug prices for those on Medicare and reducing drug spending by the federal government. But these cost reductions for Medicare may lead to employers and their employees paying the price.

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401(k) Contribution Limits Are Taking a Big Jump for 2023

The I.R.S. announced one of its largest increases in decades to caps on retirement contributions, allowing workers with access to the plans to save more.

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Pfizer Says COVID-19 Vaccine Will Cost $110-$130 Per Dose

Pfizer will charge $110 to $130 for a dose of its COVID-19 vaccine once the U.S. government stops buying the shots, but the drugmaker says it expects many people will continue receiving it for free. Pfizer executives said the commercial pricing for adult doses could start early next year, depending on when the government phases ...

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After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion

Proposed changes in Medicare rules could soon pave the way for a significant expansion in Medicare-covered dental services, while falling short of the comprehensive benefits that many Democratic lawmakers have advocated. That’s because, under current law, Medicare can pay for limited dental care only if it is medically necessary to safely treat another covered medical ...

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Watch For It! Apple To Launch Health Insurance In 2024

Apple is poised to enter the health insurance business in 2024 in partnership with a major payer, according to an industry analyst. “They are in such a strong position to do this,” Ben Wood, chief analyst at CCS Insight, told Forbes. “They’ve got a wealth of personal health data through Apple Watch. If they join some of the dots ...

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Say What? Hearing Aids Available Over-the-Counter for as Low as $199, and Without a Prescription

Starting Monday, consumers will be able to buy hearing aids directly off store shelves and at dramatically lower prices as a 2017 federal law finally takes effect. Where for decades it cost thousands of dollars to get a device that could be purchased only with a prescription from an audiologist or other hearing professional, now ...

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Biden to Get Booster, Push Businesses to Offer Vaccine Clinics

The White House is asking businesses to help employees get updated coronavirus vaccines by hosting on-site clinics and will initiate a new program providing some Americans with free home delivery of Covid-19 treatments before an expected surge of the virus this fall. President Joe Biden will announce the effort Tuesday at the White House, where ...

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