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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.

Why Generic Drugmakers Oppose Dems’ Drug Pricing Bill

Generic drugmakers are warning that Democrats’ plan to let Medicare negotiate the prices of drugs may undercut competition from lower-cost copycats, inject massive uncertainty into their market and forfeit potential long-term savings. Why it matters: Experts say the concern about downstream effects on generics is valid and point to larger questions about whether the overriding focus ...

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Congress Must Focus On Public Health To Avoid Another Crisis

Our country is on the verge of another health care crisis, and families across Nevada will pay the price if Congress fails to protect our access to affordable care and coverage.

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CVS Health Seeks to Buy Signify Health, WSJ Reports

CVS Health Corp is seeking to buy Signify Health Inc as it looks to expand in-home health services, the Wall Street Journal reported on Sunday, citing sources. Signify Health is working with bankers to explore strategic alternatives, including a sale, the Journal reported last week. Initial bids are due this coming week, and CVS is ...

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Number Of Uninsured Americans Drops To Record Low

The number of people living in America without health insurance coverage hit an all-time low of 8 percent this year, the U.S. Department of Health and Human Services announced Tuesday.

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Most Medicare Beneficiaries Worried About Inflation’s Effect On Healthcare Costs

A full 95% of Medicare beneficiaries are worried about the impact of inflation on healthcare costs. And nearly half of the 2,500 beneficiaries recently surveyed by eHealth say their healthcare costs have already increased due to inflation.

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Patient Safety Advocate Cheers CMS’ Reversal On Quality Reporting, But Hospitals Say The Data Are No Good

The Centers for Medicare & Medicaid Services (CMS) has pulled back on plans to pause public reporting on certain hospital safety data in the wake of pushback from patient safety advocates. In Monday’s release of the final Inpatient Prospective Payment System (IPPS), CMS detailed numerous changes from a fiscal year 2023 proposal it had laid out in April. ...

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Senate Dems Reach Draft Deal To Extend ACA Premiums, Lower Drug Costs

The bill, a slimmed-down version of President Joe Biden’s Build Back Better package, also allows Medicare to negotiate select prescription drug prices beginning in 2026 and caps Medicare Part D out-of-pocket costs in 2025.

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Employees Are Increasingly On The Hook For Their Medical Costs

The growth of high-deductible health plans led to people with employer-sponsored coverage paying for a larger share, on average, of their health care costs between 2013 and 2019, according to a new analysis by the Employee Benefit Research Institute.

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CMS Calls For Public Input To Improve Medicare Advantage

The CMS is asking for public feedback on how to make the Medicare Advantage program more affordable, sustainable and equitable for enrollees, while driving better health outcomes.

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Inflation-Dogged Health Systems Confident Payers Will Concede Higher Rates In 2023 Contract Negotiations

Executives from some of the country’s largest for-profit health systems say it’s likely their organizations will be able to pass rising cost pressures along to commercial insurers during the next round of contract negotiations. Speaking to investors during earnings calls this past week, the hospital chains each reported limited non-COVID volumes, supply chain interruptions and ...

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