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.
Employers (of any size) providing prescription drug coverage benefits must distribute an annual notice to all Medicare-eligible individuals by October 15th – including both employees and dependents.
A federal judge’s ruling in Texas has thrown into question whether millions of insured Americans will continue to receive some preventive medical services, such as cancer screenings and drugs that protect people from HIV infection, without making a copayment.
The Affordable Care Act (ACA) requires group health plans to spend a minimum percentage of premium dollars on members’ health care expenses and services. Likewise, it sets a threshold on the maximum amount of premium dollars that can be spent on other administrative costs, such as marketing, profits, salaries, agent commissions, etc.
Quality of care, care team choice, location and speed all play a role in how much consumers are willing to spend on their healthcare, according to new survey responses from more than 2,000 American adults. Fifty-seven percent of those polled in mid-March said they would be willing to pay more based on the quality of ...
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 ...
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 ...
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, ...
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 ...
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 ...
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 ...