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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.

Hospitals Divert Primary Care Patients to Health Center ‘Look-Alikes’ to Boost Finances

A growing number of hospitals are outsourcing often-unprofitable outpatient services for their poorest patients by setting up independent, nonprofit organizations to provide primary care. Medicare and Medicaid pay these clinics, known as federally qualified health center look-alikes, significantly more than they would if the sites were owned by hospitals. Like the nearly 1,400 federally qualified health ...

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Passage Of Inflation Reduction Act Gives Medicare Historic New Powers Over Drug Prices

Medicare is poised to renegotiate the prices of some of its most expensive drugs through a historic expansion of its power, which could reduce costs for many seniors as well as federal spending on its prescription drug plan. The changes are tucked inside a massive spending-and-tax bill in Congress that includes $433 billion in investments ...

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Aetna To Enter ACA Exchanges In 4 More States; California

Aetna will enter the Affordable Care Act’s (ACA’s) exchanges in four more states, bringing its total footprint to 12 states, the insurer announced late last week. The CVS Health subsidiary will begin offering plans in California, Delaware, Illinois and New Jersey for the 2023 plan year. Aetna already offered plans in Arizona, Florida, Georgia, Missouri, ...

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What Expanding The “Joint Employer” Rule Will Mean For Unions

The Trump administration issued rules and legal guidance that made it more difficult for unions to organize workers, and for workers to bring complaints and lawsuits against employers for alleged labor-law violations. That’s changing now that Democrats are in the White House, and Democratic appointees control the Labor Department and National Labor Relations Board. For ...

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Push To Double Up On COVID Booster And Flu Shot May Have A Downside, Experts Caution

As the promotional push to get people vaccinated with one of the updated, bivalent Covid vaccines heats up, federal health authorities are urging Americans to consider getting their Covid shot and their flu shot at the same time. And with concern about a fall wave of Covid paramount in this effort, the messaging is stressing ...

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Biden To Announce New Support For US Biotech Production

President Joe Biden is launching a new initiative to encourage biotech production and research in the U.S., the latest move by the White House to boost domestic industry. Biden on Monday signed an executive order implementing the initiative and later, in remarks at the John F. Kennedy Presidential Library in Boston, will address how biotech can help fight ...

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Biden Hopes Ending Cancer Can Be A ‘National Purpose’ For US

President Joe Biden on Monday urged Americans to come together for a new “national purpose” — his administration’s effort to end cancer “as we know it.” At the John F. Kennedy Presidential Library and Museum, Biden channeled JFK’s famed moonshot speech 60 years ago, likening the space race to his own effort and hoping it, too, would ...

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US Uninsured Rate Hits Record Low Of 8 Percent, Biden Admin Report Says

The U.S. uninsured rate fell to a record low of 8 percent in the first quarter of 2022, according to a new report from the Biden administration.

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How Do Retirement Savers Stack Up? Gen Z And Millennials Are Saving At High Rates

Recent downturns in the stock market have some retirement savers questioning the long-held wisdom that slow and steady wins the race. Between the end of March and mid-June 2022, the S&P alone dropped more than 20%, and fears of recession have many worrying that this decline is only the tip of the iceberg.

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What Happens To Patients When Telehealth Businesses Shutter?

Buzzy, venture-backed startups and big tech companies that have promised to disrupt health care are indeed doing so — including by shuttering services that early adopter patients may have come to rely on. Following its deal to acquire primary care tech company One Medical, Amazon announced it was ending its own virtual- and in-person health service Amazon ...

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