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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

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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California Will Keep Workplace Pandemic Rules Through 2022

California workplace regulators on Thursday extended mandatory pay for workers affected by the coronavirus through the end of 2022, acting more than two months after state lawmakers restored similar benefits through September.

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The Ball Is Back In Newsom’s Court On Single-Payer Health Care In California

On Monday, the commission finalized that report, which found that health care costs will skyrocket by 30% in nine years under the current system and advocates an overhaul that would eliminate distinctions among private and government coverage, in favor of a new system to provide health care to all Californians.

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Despite Losing Federal Money, State Is Still Testing Uninsured Residents for COVID — For Now

California is still offering free covid testing to uninsured residents even though the federal government ran out of money to pay for it. While Congress debates whether to put more money into free testing, California is leaning on programs it already had in place: special state-based coverage for uninsured Californians, school testing, and free tests ...

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Some California Transit Agencies Ask Riders To Still Wear Masks, Despite Court Decision

Some public transit agencies in California are asking riders to continue wearing masks on buses and trains, despite a federal court ruling in Florida on Monday that struck down the masking mandate on public transportation.

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DMHC Guidance Confirms that California Law, Not the Federal No Surprises Act, Governs Payment and Dispute Resolution Processes for Certain...

Executive Summary The California Department of Managed Health Care (“DMHC”) issued a recent guidance interpreting the application of the No Surprises Act (“NSA”)—a new federal law prohibiting out-of-network healthcare providers from balance-billing patients for certain emergency and non-emergency services—in California.  Significantly, when determining which payment and dispute resolution processes will apply in a dispute regarding the value ...

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Nevada Health Insurance Exchange Gets New Director

Ryan High has been named the new director of the Silver State Health Insurance Exchange.

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Supreme Court Weighs Employer’s Challenge To California Labor Law

The Supreme Court on Wednesday weighed an employer’s challenge to a California labor law that authorizes private attorneys to sue on behalf of thousands of workers, even if those workers had agreed to arbitrate their claims individually.

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Record Fines Might Mean California Is Finally Serious About Improving Medi-Cal

A few weeks ago, state regulators imposed a record $55 million in fines on L.A. Care, California’s largest Medi-Cal managed-care plan, for failing to ensure adequate care and allowing treatment delays that threatened enrollees’ health. Patient advocates hope the move signals stricter enforcement against other Medi-Cal insurers, which have many of the same shortcomings for which the regulators just fined L.A. Care.

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California Setting Up Statewide Medical Data-Exchange Grid

California is developing a long-sought statewide health information exchange for providers and payers to deliver better care for patients. The health information exchange, or HIE, has received little public attention. But it would cover 40 million people in California’s 58 counties, and would in part quickly inform emergency room doctors and nurses of a patient’s ...

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