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.
Affordable Care Act (ACA) marketplace officials are hoping to get more plans into value-based care arrangements as regulators hope to not just build on getting people covered, according to federal officials. Officials with the Centers for Medicare & Medicaid Services (CMS) spoke Thursday at the Health Care Payment Learning and Action Network Summit on value-based ...
Thousands of smartphone applications in Apple (AAPL.O) and Google’s (GOOGL.O) online stores contain computer code developed by a technology company, Pushwoosh, that presents itself as based in the United States, but is actually Russian, Reuters has found. The Centers for Disease Control and Prevention (CDC), the United States’ main agency for fighting major health threats, said it had been ...
Technological innovations and changing work arrangements brought on by the COVID-19 pandemic are among some of the emerging issues that can make employers vulnerable to discrimination lawsuits, a top employment practices defense attorney said Thursday. Barry A. Hartstein, co-chair of the Equal Employment Opportunity & Diversity Practice for the Littler Mendelson law firm in Chicago, ...
Paul Roberts, Word & Brown’s Senior Director of Education and Market Development, hosted a conversation this week with Janet Trautwein, CEO of the National Association of Health Underwriters (NAHU) and President of the NAHU Education Foundation, concerning the November 2022 election.
When it comes to price negotiations for healthcare services between hospitals and insurance companies or self-insured employers, hospitals appear to be winning big time, according to a study in Radiology.
Last year, the estimated Medicare fee-for-service improper payment rate was more than 6%, representing more than $25 billion in improper payments. Despite the historic low, the rate rose in some areas like skilled nursing facilities. Managing claims is difficult and complex. One recent study found that nearly a third of healthcare resources are tied up in administrative costs, taking focus away ...
More than half, or 58%, of health plan members are “overwhelmed” when it comes to managing their health plans. Insurers need to provide information in a way that's accessible and easy to understand, the report stated.
Employers typically offer a period of open enrollment in the fall, when their workers are allowed to pick new health plans, enroll in a Flexible Spending Account or make other changes to their benefits. This year, there are some changes ahead that could help employees, while also potentially opening up some financial pitfalls.
Originally passed in 2018 and effective in 2020, the California Consumer Privacy Act (CCPA) is a comprehensive privacy law aimed at enhancing California residents’ privacy rights and consumer protection.
The Biden Administration released a final rule in October 2022, which closes the longstanding family glitch in the Affordable Care Act (ACA). The rule goes into effect on December 12, 2022, and it impacts Individual and Family Plan (IFP) coverage and employer-sponsored coverage effective in 2023.