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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.

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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Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds.

Atrium Health, the largest hospital system in North Carolina, has declared publicly that in 2019 it provided $640 million in services to Medicare patients that were never paid for, by far the largest “community benefit” it provided that year. Like other nonprofit hospitals around the nation, Atrium logs losses on the federal health insurance program ...

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Inflation Is Near A Four-Decade High. So Why Aren't Health Care Costs Significantly Higher?

As consumers choose a 2023 health insurance plan from employers in coming weeks, many will find rate hikes are modest when compared to everyday living expenses. It’s the first time in over three decades that overall inflation accelerated at a faster rate than medical costs.

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New Biden Order Wants CMMI To Test Payment Models That Tackle High Drug Prices

President Joe Biden is calling for new payment and delivery models that will lower drug prices in a new executive order. The order released Friday calls on the Department of Health and Human Services to craft a report outlining the payment models that will test how to improve access to innovative drugs and lower costs for those ...

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