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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.

UnitedHealthcare, Kaiser Appeal ACA Risk-Corridor Settlement Deal

A group of insurers led by UnitedHealthcare and Kaiser Foundation Health Plan subsidiaries asked a federal judge to slash the $184 million in lawyers fees owed after winning health plans $3.7 billion from two class-actions related to a now-expired Affordable Care Act program. More than 30 insurers wrote to the U.S. Court of Appeals for ...

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IBM Sells Watson Health Assets To Investment Firm Francisco Partners

IBM has reached a deal to sell the healthcare data and analytics assets from its Watson Health business to investment firm Francisco Partners, the companies announced Friday. The companies did not disclose financial terms of the deal, but previous reports said IBM was seeking a price in the $1 billion range, Axois reported, citing people familiar ...

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Five Important Changes For Group Health Clients In 2022

The new year brings with it changes for employers, employees, and group health insurance. Here’s information you may want to share with your clients. 2022 Health Insurance Changes 1: Increased FSA Contribution Limits The Internal Revenue Service (IRS) previously published the increased limits for contributions to Health Flexible Spending Accounts (Health FSAs) in 2022. The ...

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Lawmakers Ratchet Up Pressure On CMS To Change Part B Premiums After Aduhelm Price Drop

House Democrats are ramping up pressure on the Biden administration to lower Medicare Part B premiums after the price for controversial drug Aduhelm was slashed in half.

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Competition Drives Medicare Advantage Plans To Offer Special Benefits In 2022

A quarter of Medicare Advantage plans now offer chronically ill beneficiaries healthy food, transportation and other special supplemental benefits in 2022, representing a nearly 40% year-over-year increase in carrier uptake of these unconventional services, a new study found. The report, released by consultancy ATI Advisory on Wednesday, found that 1,292 Medicare Advantage plans offered special ...

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As Enrollment On The ACA Exchanges Surges, Insurer Participation Growth Is More Modest: Study

The number of plans offered under the Affordable Care Act (ACA) for 2022 hit 15,638, up 15% from the 2021 plan year, according to a new analysis. While membership in exchange plans skyrocketed over the course of 2021, thanks to a lengthy special enrollment period under the pandemic and enhanced premium tax credits, insurer participation ...

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Mark Cuban’s Drug Company Launches Pharmacy, Promising Striking Savings On Generic Drugs

Mark Cuban Cost Plus Drug Company (MCCPDC) has launched its online pharmacy as part of an ongoing effort to provide consumers with low drug prices. The pharmacy claims to offer significant savings, with several prescription drugs reportedly at more than half the cost of the next most affordable option. For instance, leukemia treatment imatinib has ...

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CMS Issued Over 300 Warnings, But No Fines, To Hospitals Falling Short On Price Transparency Last Year

After roughly a year of requiring hospitals to publicly post their prices, the top federal health regulator has delivered hundreds of warnings but has not yet seen fit to issue any civil monetary penalties. As of an early December tally, the Centers for Medicare & Medicaid Services (CMS) had issued roughly 335 warning notices to ...

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Here’s How to Get Your Free Home COVID Test Kits

Home COVID tests are now available at no cost to most Americans, as part of the Biden administration’s effort to increase testing around the United States. Folks can buy home tests online or in stores and be fully reimbursed by their private insurance, without any copays or deductibles. The White House also plans to distribute 1 ...

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Businesses React To Ruling Against Biden Vaccine Mandate

For companies that were waiting to hear from the U.S. Supreme Court before deciding whether to require vaccinations or regular coronavirus testing for workers, the next move is up to them. Many large corporations were silent on Thursday’s ruling by the high court to block a requirement that workers at businesses with at least 100 employees be ...

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