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.
Mark Cuban, the billionaire owner of the Dallas Mavericks and “Shark Tank” star, has a new online pharmacy that could make your prescription medications more affordable. In January, Cuban announced the launch of the Mark Cuban Cost Plus Drug Company. Currently, 150 generic prescription medications are available on the pharmacy website, costplusdrugs.com. Medications are priced at ...
The Centers for Medicare & Medicaid Services is responding to the chaos of the covid-19 pandemic by proposing to hide from the public a rating that lets consumers compare hospitals’ safety records and to waive approximately $350 million in financial penalties for roughly 750 hospitals with the worst patient-safety track records. CMS’ chief medical officer, Dr. Lee Fleisher, said those ...
An analysis of three existing payment models found certain screening tools and other designs led to some Medicare beneficiaries being excluded and prompted the creation of a new guide on how to root out bias in models. Researchers with the Center for Medicare and Medicaid Innovation (CMMI) outlined in a Health Affairs article troubling instances of implicit ...
As of July 1, employer-sponsored plans will be required to comply with transparency requirements first passed in 2020. But questions remain over whether these new rules will truly help consumers.
The grinding two-plus years of the pandemic have yielded outsize benefits for one company — Pfizer — making it both highly influential and hugely profitable as COVID-19 continues to infect tens of thousands of people and kill hundreds each day.
Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday.
Companies that offer high-deductible health plans (HDHPs) are seeing significant dissatisfaction from employees when it comes to drug utilization management, a new report has found.
Moderna released study results today showing its new Omicron-specific booster increased antibodies against the coronavirus by a factor of 5, even against some of the newer and more worrisome variants.
Hospital groups are making a last-minute push to prevent Congress from including cuts to safety net hospitals in a massive $1.75 trillion infrastructure package.
Hospitals, public health agencies and other providers have no systematic way to share patient data among themselves, limiting their ability to monitor trends and work efficiently. Under the state’s new data-sharing requirement, a doctor or case worker could get immediate access to a patient’s full medical history, and patients could view their own records easily.