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.
Affordable Care Act officials need to start letting consumers know that enhanced subsidies will be in place for next year, the head of the Centers for Medicare & Medicaid Services (CMS) said. But Congress has yet to pass legislation extending the boosted subsidies past this year, causing new alarm from CMS and state-run exchanges as ...
The Supreme Court ruled 7-2 Tuesday that a group health plan in Ohio didn’t violate federal law by offering limited coverage for outpatient dialysis in a case brought by DaVita, one of the largest dialysis providers in the United States. The court sided with Marietta Memorial Hospital’s employee health plan, with Justice Brett M. Kavanaugh writing in ...
Medicare could have saved nearly $4 billion in 2020 by purchasing generic drugs at the same prices offered by Cost Plus Drug Company, Cuban's online pharmacy that launched this year, according to a study published Monday in the journal Annals of Internal Medicine.
Workers’ compensation claims can result directly from worksite conditions, whether in construction, manufacturing, distribution, office or other environments. The Occupational Safety and Health Administration (OSHA) tracks violations of safety and health standards, which can lead to workers’ comp claims.
Harmony is not often found between two of the most boisterous senators on Capitol Hill, Bernie Sanders (I-Vt.) and Rand Paul (R-Ky.). But it was there at Tuesday’s Senate Health, Education, Labor and Pensions Committee markup of legislation to reauthorize the Food and Drug Administration’s user fee program, which is set to expire Sept. 30. This user fee program, which ...
Flexible spending accounts can be a useful way for workers to stretch health-care spending dollars further than they otherwise could. However, little is known about how workers use — or don’t use — FSAs. In response, the Employee Benefit Research Institute established the FSA Database to shine a light on this under-researched employee benefit. Analysis of this ...
The American Hospital Association has urged the Centers for Medicare and Medicaid Services to extend enforcement discretion for the No Surprises Act regulatory requirement that healthcare providers exchange certain information to create a good faith estimate for uninsured and self-pay patients – until the agency identifies, and providers can implement, a standard, automated way to exchange the ...
Transparency is an ongoing, major focal point in the health insurance and health care industries. Federal and state laws have been enacted across the country, aimed at making the costs of health care and health insurance more available, transparent, and digestible for consumers and the general public. In 2020, the Departments of Health and Human ...
Four in 10 employees deferred healthcare in the past year, according to a new report from Willis Towers Watson. The survey, which polled more than 9,600 workers in the U.S., found that 28% delayed or canceled a medical procedure, while 17% did not fill a prescription. Twenty percent of those surveyed said their provider canceled the ...
Hospital groups and providers are demanding the Biden administration increase a proposed 3.2% pay bump for inpatient payments to facilities, arguing inflation and a staffing crisis are still hitting them hard. The Centers for Medicare & Medicaid Services (CMS) proposed the pay bump for fiscal year 2023 as part of the Inpatient Prospective Payment System ...