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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.

Arbiters To Expand Surprise Billing Dispute Resolution Reviews, CMS Says

Surprise billing dispute arbiters will need to consider information in addition to median contracted rates for billed items or services, the Centers for Medicare and Medicaid Services said in revised guidance. Providers and health insurers can submit the following types of information to influence arbiters’ decisions on qualifying payment amounts: * Training, experience and quality ...

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FDA Grants Emergency Authorization For First COVID-19 Breathalyzer Test

Americans will be able to find out if they have COVID-19 with a breathalyzer test, the Food and Drug Administration announced Thursday. The FDA granted an emergency use authorization to a test produced by InspectIR Systems that collects a breath sample and analyzes for chemical compounds associated with the coronavirus, the first of its kind to ...

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ACA Marketplace Premiums Decline For Third Consecutive Year, Urban Institute Finds

Dive Brief: * The average premium for ACA marketplace coverage dipped 1.8% in 2022 compared with the prior year, an analysis from the Urban Institute, funded by the Robert Wood Johnson Foundation, found. * It’s the third consecutive year average ACA premiums declined, bucking the trend of sustained increases for job-based coverage, which provides insurance to a majority ...

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CMS Proposes Acute Hospitals Get 3.2% Pay Bump In 2023, Calls For Equity Quality Measures

The Biden administration is proposing that acute care hospitals get a 3.2% increase in payments for federal fiscal 2023 and to install new quality measures focused on health equity. The Centers for Medicare & Medicaid Services (CMS) released its proposed Inpatient Prospective Payment System (IPPS) rule and a separate rule for long-term care hospitals. The ...

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FEDERAL “NO SURPRISES ACT” HEALTH PLAN CHANGES – 2022 UPDATE

The federal Consolidated Appropriations Act (CAA) of 2021 brings significant changes to the American health care and health insurance industries – as well as many other changes to unrelated sectors.

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DHHS Distributes More Than $43M To Support Behavioral Health Needs Throughout Nevada

The Department of Health and Human Services announces the distribution of more than $43 million to support behavioral health needs throughout Nevada, the group announced Friday.

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The New White House COVID Czar Calls For Calm As Cases Rise, Driven By BA.2

The U.S. should use this moment when coronavirus cases are relatively low to prepare for a "likely" surge in the future, according to an assessment from the new White House coronavirus response coordinator.

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Coronavirus Cases On The Rise In L.A. County, Prompting Calls For Spring Break Caution

Coronavirus cases are once again on the rise in Los Angeles County, according to data released Monday, prompting officials to urge residents to keep up safety protocols as the spring break holiday season arrives.

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Your Next COVID-19 Vaccine Will Be Different

After deploying four COVID-19 shots in a little more than two years, the nation is absorbing a troubling realization: That’s a pace that’s impossible to sustain.

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FDA Mulls Drug Importation With States

The FDA has started discussions with states over creating a way to import drugs from Canada — a policy the Biden and Trump administrations both embraced to bring down health costs but which experts regard as having limited impact.    

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