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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.

Most Hospitals Not In Compliance With Federal Price Transparency Rules

After three years, only a third of 2,000 U.S. hospitals reviewed were in compliance with the Hospital Price Transparency Rule of 2021, says a new PRA report, which puts some of the blame on feds for not enforcing the rule.

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Single-Payer Healthcare Meets Its Fate Again In The Face Of California’s Massive Budget Deficit

The latest attempt to bring a single-payer healthcare system to California failed in the state Legislature on Thursday, undercut by its steep price tag as lawmakers struggle with a mounting budget shortfall.

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HHS Unveils New $50M Program To Protect Hospitals From Cyberattacks

Following the Change Healthcare and Ascension breaches, this new HHS program will solicit proposals from companies that can create tools to ensure internet-connected hospital equipment is kept safe and functional.

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Legal Battle Over Health Costs Could Change Workplace Benefits

An emerging legal battle over workplace health insurance could empower employees to fight back against high costs and put new pressure on their employers. Why it matters: Workers fed up with rising health care costs, which also eat into their wages, are filing lawsuits aiming to hold employers accountable for cutting what they say are bad deals with firms ...

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Justice Department ‘Upping Its Game’ On Healthcare Antitrust Enforcement With New Task Force

The U.S. Department of Justice (DOJ) announced Thursday it has established a new task force to take on healthcare monopolies and collusion. The task force, called HCMC for short, will guide the division’s enforcement strategy and policy approach in healthcare, including by facilitating policy advocacy, investigations and, where warranted, civil and criminal enforcement in healthcare ...

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Biden Races Clock On Health Regulations With Eye On Potential Trump Return

President Biden’s administration is working overtime to ensure his health care priorities are protected from a potential second Trump White House. In recent weeks, regulatory agencies have been racing against the clock to finalize some of their most consequential policies.

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Final Prior Authorization Rules Look to Streamline the Process, but Issues Remain

As concerns continue to be raised about consumer barriers to care resulting from prior authorization requirements, the federal government issued a final regulation aimed at streamlining and automating the prior authorization process and improving transparency for certain payers.

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Biden Team’s Tightrope: Reining In Rogue Obamacare Agents Without Slowing Enrollment

President Joe Biden counts among his accomplishments the record-high number of people, more than 21 million, who enrolled in Obamacare plans this year. Behind the scenes, however, federal regulators are contending with a problem that affects people’s coverage: rogue brokers who have signed people up for Affordable Care Act plans, or switched them into new ...

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DOL Reverses Trump-Era ‘Multiple Employer’ Association Health Plan Rule

The 2018 rule sought to expand opportunities for smaller employers to join together to serve as the sponsor of a single, multiemployer health plan but was never implemented after a court ruling blocked it.

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Drugmakers, Hospitals Spar Over New 340B Drug Discount ‘Dispute Resolution’ Process

The new dispute resolution process is designed to use government officials to oversee disagreements, however, lobby group PhRMA said the new process "panders to 340B hospitals" while ignoring drugmakers' concerns.

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