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.
In a recent report, analysts at management consulting firm McKinsey have outlined the risks inflation poses to the insurance industry, noting how US P&C insurers can build resilience against it. The report writes that the insurance industry faced profitability challenges even before the pandemic, and the sudden unexpected spike in inflation has only added to ...
CVS Health has acquired Signify Health, besting Amazon, UnitedHealth Group and others in acquiring the home health platform. CVS has entered a definitive agreement to acquire Signify Health for $30.50 per share in cash, representing a total transaction value of approximately $8 billion, CVS announced on Monday. Signify was reportedly for sale by auction, with board members holding a meeting on ...
The Biden administration needs to back off a massive overhaul to risk adjustment audits for Medicare Advantage (MA) plans, according to insurers that say the proposal unfairly targets prior audits dating back a decade. Insurer advocacy groups and providers submitted comments to a request for information on how to improve the MA program. Insurers turned ...
In order to stay in sync with the latest Centers for Disease Control and Prevention (CDC) recommendations, it’s time to say bye, bye, bye to the original Covid-19 mRNA booster vaccines. Or perhaps bivalent, bivalent, bivalent. Going forward, bivalent versions of the Pfizer/BioNTech and Moderna Covid-19 mRNA boosters are what’s going to be available, replacing ...
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus said on Friday that the recent decline in monkeypox cases that has been observed in North America and Europe is evidence that the current outbreak can be stopped or eliminated outright. Tedros made note of how monkeypox has quickly grown in prominence from being a little-known virus that was ...
The Biden administration proposed new regulations aimed at overhauling the application and renewal processes for Medicaid and other government programs, including ensuring a beneficiary’s returned mail doesn’t automatically lead to coverage denials. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule that makes changes to the enrollment process for Medicaid, Children’s Health Insurance Program ...
Healthcare prices have increased over the past year, and typically care prices and overall health spending outpace growth in the rest of the economy.
Cancer care has become the top driver of large employers' health care costs due to an increase in late-stage diagnoses, according to a new survey from the Business Group on Health.
The online retail giant revealed plans last week to shutter Amazon Care, its in-house business providing virtual and in-person medical services. The business launched in 2019 as a pilot project and then quickly expanded its telehealth services to all 50 states
For the second quarter in a row, the insurance industry saw the largest year-over-year growth in digital fraud attempts with an increase of 159% from Q2 2021 to Q2 2022, according to TransUnion’s latest quarterly fraud analysis report.