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.
Medicare recipients will get a premium reduction — but not until next year — reflecting what Health and Human Services Secretary Xavier Becerra said Friday was an overestimate in costs of covering an expensive and controversial new Alzheimer’s drug. Becerra’s statement said the 2022 premium should be adjusted downward but legal and operational hurdles prevented ...
Pharmacists and drug wholesalers can import prescription medicines from Canada for up to two years as part of state programs aimed at bringing down drug costs, according to final FDA guidance released Thursday. Why it matters: With President Biden’s drug pricing agenda still stalled, the FDA is further clarifying how states could take advantage of lower drug costs ...
A survey by AHIP and the Blue Cross Blue Shield Association shows The No Surprises Act, which was passed with the intent of preventing surprise medical bills, has lived up to that goal by preventing more than 2 million surprise medical bills across all commercially insured patients.
Cigna’s Evernorth and Kaiser Permanente have inked a multi-year network agreement that aims to drive greater convenience and affordability. The five-year collaboration will first center on enhancing access and convenience for Kaiser Permanente members by offering access to Cigna’s PPO network for emergency and urgent care outside of the health system’s service areas. Specialty pharmacy is ...
Higher salary employees are more likely to seek regular preventive care, while low-income workers have higher emergency services utilization.
The healthcare industry likely has until this fall to face the end of the COVID-19 public health emergency (PHE) as a key deadline came and went with no notice Monday. The Department of Health and Human Services (HHS) promised to give states a 60-day notice when the PHE will end, giving a vital heads-up for ...
Health insurance trade group AHIP is calling for the White House and Congress to increase scrutiny of private equity control of providers, which the group worries could impact quality and costs. The group earlier this week released letters sent to the White House and congressional leaders outlining parts of a new policy road map and priorities (PDF). ...
Health insurers are now submitting to state regulators proposed 2023 premiums for plans offered on the Affordable Care Act (ACA) Marketplaces. Changes in these unsubsidized premiums attract a lot of attention, but what really matters most to the people buying coverage is how much they pay out of their own pockets. And the amount ACA ...
The health insurance industry wants politicians to demand more transparency from private capital healthcare deals and increase oversight from health system consolidation, trade group AHIP wrote in letters to President Joe Biden and congressional leaders on Monday. AHIP describes policies that it believes will improve competition in the healthcare system and reduce costs. “In too ...
When she was Pennsylvania’s insurance commissioner, Jessica Altman, the appointee of a Democratic governor, often bumped against the political limits of health care policy in a state where Republicans controlled the legislature. Despite the constraints of a divided government, Altman played a key role in persuading lawmakers in 2019 to join Gov. Tom Wolf in passing ...