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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.

New Survey Assesses The Biggest Hurdles, Goals For Health Plans Amid A Rapidly Changing Landscape

A dramatic pickup in the pace of change for payers in the last year has created new priorities for health plan leaders, a new survey has found. The survey, conducted by payment integrity solution HealthEdge, reached more than 300 health plan leaders. Common themes, per a report of the survey results, included the move to ...

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Biden Signs Sweeping Bill To Tackle Climate Change, Lower Health-Care Costs

President Biden on Tuesday signed into law the Inflation Reduction Act, an ambitious measure that aims to tamp down on inflation, lower prescription drug prices, tackle climate change, reduce the deficit and impose a minimum tax on profits of the largest corporations.

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The Inflation Reduction Act Is About To Become Law. What It Will Do For Californians

Now that the approximately $700-billion package is set to become law, what will it mean for you? Here’s a look at how the bill’s provisions could impact Californians.

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Health Benefit Cost Growth Will Accelerate to 5.6% in 2023, Mercer Survey Finds

US employers expect health benefit cost per employee to rise 5.6% on average in 2023, according to early results from Mercer’s National Survey of Employer-Sponsored Health Plans 2022, which launched June 22 this year and remains open.

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The Coming Public-Private Drug Pricing Divide

Democrats are on the cusp of their most significant health policy victory since passage of the Affordable Care Act, but the legislative wrangling it took to get here came at a steep cost: The prescription drug pricing reforms included in the health, tax and climate package are limited to Medicare and exclude the millions of Americans with private insurance.

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After Wiping Out $6.7 Billion in Medical Debt, This Nonprofit Is Just Getting Started

Soon after giving birth to a daughter two months premature, Terri Logan received a bill from the hospital. She recoiled from the string of numbers separated by commas. Logan, who was a high school math teacher in Georgia, shoved it aside and ignored subsequent bills. She was a single mom who knew she had no ...

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Health Plan Leaders Try To Keep Up With Changing Industry, Study Finds

Managing costs and finding operational efficiencies topped the list of things that health plan leaders are concerned with, according to a new survey from HealthEdge. The digital health solutions company surveyed more than 300 health plan officials from a range of payer types, with the goal of providing a better understanding of what is top of mind ...

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Health Care Providers Are Shouldering Rising Costs. That Could Change Soon.

While the economy as a whole has experienced record-breaking inflation this year, price increases in the health care sector have been relatively subdued — a trend that could end soon as Medicare and other payers adjust to new economic realities. Rising costs, such as labor, have largely not translated to higher medical prices, in part ...

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Community Health Centers’ Big Profits Raise Questions About Federal Oversight

Just off the deserted town square, with its many boarded-up businesses, people lined up at the walk-up pharmacy window at Genesis Health Care, a federally funded clinic. Drug sales provide the bulk of the revenue for Genesis, a nonprofit community health center treating about 11,000 mostly low-income patients in seven clinics across South Carolina. Those ...

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US Offers More Monkeypox Vaccine To States And Cities

U.S. officials said they are able to ship out more monkeypox vaccine doses than previously planned — because of a strategy shift that allows more shots to be drawn from each vial. The U.S. Department of Health and Human Services had previously anticipated allowing 221,000 doses to be ordered starting Monday. But officials said they ...

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