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.
While the conversation at the House E&C Subcommittee hearing this morning was fairly varied, in the early questioning before the Ways and Means Committee, the debate over the Affordable Care Act has been front and center. Ranking Member Richard Neal, D-Massachusetts, said in his opening remarks that the expiry of the enhanced subsidies in the ...
President Donald Trump has hinted at “concepts of a plan” for healthcare for months as legislators debate the future of key subsidies under the Affordable Care Act, and on Thursday the White House unveiled a more concrete version of its vision for health policy. Called “The Great Healthcare Plan,” Trump’s proposal would send the value ...
Several medical organizations have asked a judge to declare the U.S. Centers for Disease Control and Prevention’s decision this month to narrow the list of vaccines recommended for children unlawful, calling the move “egregious, reckless, and dangerous.” The American Academy of Pediatrics and a coalition of other medical groups on Monday moved to expand a lawsuit, ...
Anthem Blue Cross accused 11 Prime Healthcare hospitals of fraud in a lawsuit filed this week in a California federal court. The defendants submitted and were compensated for thousands of claims for independent dispute resolution under the No Surprises Act despite knowing they were false, the insurer alleged. “We are holding billing companies and out-of-network ...
Members of the U.S. House today voted 221-205 to bring an Affordable Care Act health insurance premium subsidy bill resolution up on the House floor, against the wishes of Republican House leaders. The resolution could lead to floor consideration of an ACA premium subsidy bill. The underlying bill could keep the high ACA premium subsidy ...
The hospital lobby has scored a court-ordered pause on the federal government’s 340B Rebate Model Pilot Program just days before it was set to begin. On Dec. 29, U.S. District Judge Lance Walker, the chief of the U.S. District Court for the District of Maine, ordered a preliminary injunction against the “hastily assembled” pilot set ...
Lawmakers have introduced a bipartisan bill that could apply Employee Retirement Income Security Act fiduciary requirements to employer health plans’ pharmacy benefit managers. The bill, the PBM Fiduciary, Accountability, Integrity and Reform Act, or PBM FAIR Act, would add a PBM fiduciary section to ERISA section 3(21), according to a version of the text posted by Sen. Roger ...
UPDATED: 7:45 p.m. on Dec. 17 The House of Representatives passed a Republican-led package that seeks to address the affordability of healthcare without an extension of the soon-to-expire Affordable Care Act subsidies. The 216-211 vote averted a last-ditch effort from Democrats and several moderate Republicans to force a vote on a subsidy extension. All Democrats ...
Four House Republicans who are worried about the Affordable Care Act health insurance “subsidy cliff” are trying to help House Democrats force a vote by the full House on a subsidy extension bill. The Republicans today signed a discharge petition that calls for the House to bring a subsidy extension resolution up for a vote ...
As Congress debates whether to extend the temporary federal subsidies that have helped millions of Americans buy health coverage, a crucial underlying reality is sometimes overlooked: Those subsidies are merely a band-aid covering the often unaffordable cost of health care. California, Massachusetts, Connecticut, and five other states have set caps on health care spending in a bid to rein ...