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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.

Mental Health Shouldn’t Be “Treated Like A Stepchild” To Physical Health, Says HHS Chief

The Biden administration plans to ramp up mental health services to aid millions of Americans struggling from the disruptions, hardships and grief of the COVID-19 pandemic, the nation’s top federal health official says, but needs more money from Congress to do “transformative work on mental health.” The comments by Health and Human Services Secretary Xavier ...

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Naomi Judd’s Death Spotlights A National Mental Health Crisis Worsened By COVID-19

Millions of Americans struggled with their mental health well before COVID-19, but the pandemic hasn’t made shouldering mental illness any easier – an issue brought to light over the weekend after the death of country music star Naomi Judd.

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CMS Finalizes Rule That Calls For Standardized Plan Options, Network Adequacy Reviews For ACA Exchanges

Insurers on the Affordable Care Act will have to develop standardized plan options and prepare for network adequacy audits on the law’s insurance exchanges starting next year, according to a final rule. 

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Is Hybrid The New Normal? Workers Are Back In Person But Only A Few Days A Week

In-office presence varies by industry in Los Angeles County, with tech and entertainment-related businesses in the forefront, but the easing of pandemic safety restrictions in early March has clearly led to an increase in work getting done at the office instead of at home, landlords said.

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U.S. Hospitals Struggle to Absorb Pandemic-Era Rising Costs

Labor costs per patient jumped by 19% in 2021 from 2019, and supplies rose by over 20% per patient during that period, according to the report. Nursing expenses shifted heavily toward travel nurses. The travelers’ share of nursing budgets rose to 39% in 2022 from 5% in 2019.

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Employers Still Overlooking A Big Factor That’s Fueling Burnout

Burnout has been on the rise since the start of pandemic — a trend that been a big factor in the turnover tsunami that has swept the nation.

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CMS Proposes 5 Medicare Special Enrollment Periods

Medicare beneficiaries experiencing specific illnesses or circumstances could soon get Part B coverage outside the normal open enrollment periods under a proposed rule released Friday. Individuals who are impacted by an emergency or disaster, formerly incarcerated people and those subject to a health plan or employer error that prevented them from enrolling in Medicare on ...

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Trump Era Rule That Expanded Duration Of Short-Term Health Plans In Democrats’ Crosshairs

Democratic lawmakers and advocacy groups are making a push to convince the Biden administration to nix a controversial Trump-era rule that expanded the duration of short-term health plans. A collection of more than 40 House Democrats wrote to Department Health and Human Services (HHS) Secretary Xavier Becerra earlier this week calling for the agency to ...

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KLAS: Hospitals Say Price Transparency Remains Too Confusing And Pricey To Implement

Hospitals and health systems believe a price transparency rule, while well-intentioned, is far too expensive to implement and is confusing, a new report found. The report released Thursday from the health IT firm KLAS Research underscores major compliance issues surrounding a landmark rule that requires hospitals to post payer-negotiated rates for certain services in an easy-to-understand format. ...

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HHS To Appeal Texas Ruling That Struck Down Key Parts Of Surprise Billing Rule

The Biden administration has filed an appeal to a ruling that vacated key parts of a rule that bans surprise medical bills. The Department of Health and Human Services announced in a legal filing late Friday that it is appealing the ruling to the U.S. Court of Appeals for the Fifth Circuit. The decision to ...

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