Government Mandates and Compliance

//Government Mandates and Compliance

Profits from CSR Payments Examined by Judges

On Thursday, judges from the U.S. Court of Appeals for the Federal Circuit raised their concerns that insurers were overly compensated from the subsidies received from the government is giving them, which were given due to the losses from cost-sharing reduction payments. In October 2017, the cost-sharing reduction payments were cut from insurers, and was originally [...]

By | 2020-01-10T10:01:02+00:00 January 10th, 2020|Articles, Government Mandates and Compliance|0 Comments

Stark Law Changes Supported by Physicians, Hospitals

The Centers for Medicare and Medicaid Services (CMS) are pushing to change Stark law statutes to facilitate providers to be in value-based contracts without the concern of being blamed for kickbacks. The Stark law, which is the anti-kickback and self-referral laws,  aid more value-based payments and coordinated care, while preventing physicians from benefiting and profiting [...]

By | 2020-01-03T10:08:54+00:00 January 3rd, 2020|Articles, Government Mandates and Compliance|0 Comments

Surprise Billing Legislation Omitted from Year-End Spending Deal

After months of debate over surprise billing and how to protect patients from out-of-network charges, lawmakers were not able to come to a compromise on the surprise billing proposal, failing to get the bill included in the 2019 year-end spending deal. The spending deal was an opportunity for the surprise billing legislation to be passed. [...]

By | 2019-12-27T10:10:21+00:00 December 27th, 2019|Articles, Government Mandates and Compliance|0 Comments

Risk Corridor Payments Brought to Supreme Court

On Tuesday, the United States Supreme Court heard a lawsuit pertaining to unpaid risk corridor payments ranging from 2014 to 2016. Risk corridor payments are a component of the Affordable Care Act that limits the risk from qualified health plans on the insurance marketplaces that work to minimize year-end losses of insurers who cover older, [...]

By | 2019-12-12T10:15:12+00:00 December 12th, 2019|Articles, Government Mandates and Compliance|0 Comments

Finalized Rule Can Jeopardize Legal Immigrants Residency for Using Medicaid

The Trump Administration finalized a rule on Monday that allows for legal immigrants to have their legal status threatened if these individuals utilize certain government benefits, such as Medicaid. The rule was published by the Federal Register by the Department of Homeland Security and will give authority to federal immigration officials to scrutinize the use [...]

By | 2019-08-16T13:44:36+00:00 August 16th, 2019|Articles, Government Mandates and Compliance|0 Comments

Hospitals, Insurers Dispute Price Transparency Proposed Rule

Earlier this week, the Trump Administration had announced a proposed rule that will require hospitals to publicly post their prices for services on their websites. These prices are highly regarded by hospitals as secretive, as these are rates that are privately negotiated with healthcare insurance companies. Hospitals and insurers are speaking out against this rule, [...]

By | 2019-08-02T10:16:36+00:00 August 2nd, 2019|Articles, Government Mandates and Compliance|0 Comments

Short Term Health Plans Approved by Federal Judge

U.S. District Judge Richard Leon in Washington D.C. has ruled that short-term, limited-duration health insurance plan expansions are approved to move forward. In a court ruling, the Association for Community Affiliated Plans had attempted top strike down the Trump Administration's motion to expand the short-term plans, but had lost in the ruling. The Association for [...]

By | 2019-07-26T10:31:13+00:00 July 26th, 2019|Articles, Government Mandates and Compliance|0 Comments

Executive Order Issued on Healthcare Price Transparency

On Monday, June 24th, 2019, the Trump Administration will enact an executive order on the transparency of healthcare pricing. Within the order, healthcare providers and insurers will be required to disclose information about their negotiated rates and discounts. Through the Outpatient Prospective Payment System (OPPS) rule, federal agencies will be required start the regulatory process [...]

By | 2019-06-21T09:09:54+00:00 June 21st, 2019|Articles, Government Mandates and Compliance|0 Comments