2020 and ACA - Health Care Compliance Brief

ACA Reporting Deadline Extended and the End of “Good Faith” Compliance

Compliance Now

NOVEMBER 24, 2021

On November 22, 2021, the Internal Revenue Service (IRS) published proposed regulations that introduce significant changes to the Affordable Care Act (ACA) reporting process for both large and small employers. Since 2015, the IRS has also provided good faith transition relief to ACA reporting. How Do these Regulations Impact Employers?

ACA

ACA Compliance

Financial Health Is On Americans’ Minds Just Weeks Before the 2020 Elections

Health Populi

OCTOBER 7, 2020

As Americans approach November 3, 2020, the day of the real-time U.S. Twenty-seven days before the 2020 elections, 7 in 10 Americans say their financial health will influence their votes this year, according to the doxoINSIGHTS survey which shows personal financial health as a key voter consideration in the Presidential election.

COVID-19

COVID-19 Public Health Health Insurance Health Care Access

Out-of-Pocket and Prescription Drug Costs – Connecting Digital Health Dots at CES 2020

Health Populi

JANUARY 9, 2020

Health care is the top issue driving voters’ choices in the 2020 elections for most Americans. For overall healthcare reform, the plurality of Americans prefer improving the current system (that is, building on the Affordable Care Act) versus repealing and replacing the ACA or adopting a Medicare for All plan.

ACA

ACA FDA Public Health Medicare

Biden Administration Announces 2023 Out-of-Pocket Limits and PCORI Fee for the Upcoming Year

Compliance Now

JANUARY 13, 2022

To comply with the ACA, non-grandfathered health plans cannot require a participant to pay more out-of-pocket during the plan year than the amounts listed below. Under the ACA, the out-of-pocket limitation requirement directly applies to essential health benefits. This is a $.13

ACA

ACA Health Insurance Medicaid Medicaid

Medical Debt in the U.S. Greater in States That Did Not Expand Medicaid

Health Populi

JULY 20, 2021

The level of medical debt in America exceeded debt of other types in 2020. Note that the line in 2020 nearly touches the x-axis, tending toward “zero,” or very scant medical debt. The highest turquoise blue line shows medical debt in collections in states that never expanded Medicaid with the ACA.

Medicaid

Medicaid Medicaid ACA Doctors

The 2022 US Health System Report Card: Pretty Terrific If You Live in Hawaii or Massachusetts

Health Populi

JUNE 22, 2022

Here for 2022, the second chart tracks the “stark toll” of the COVID-19 pandemic and the excess deaths experienced for each state since the pandemic emerged in February 2020. deaths per 100,000 population between 2019 and 2020. Pre-pandemic, that rate was even for eight years, then this jump spiked in 2020.

COVID-19

COVID-19 ACA Public Health Health Outcomes

U.S. Supreme Court Holds Healthcare Entities Not Liable for Emotional Injury Damages Under Certain Anti-Discrimination Statutes

Health Law RX

MAY 3, 2022

Federal appeals courts have been split on whether such damages are available to plaintiffs bringing discrimination claims under the Rehabilitation Act of 1973 (Rehab Act) and the Patient Protection and Affordable Care Act (ACA). Clayton County (2020). The Rehab Act bars funding recipients from discriminating because of disability.

ACA

ACA Medicaid Medicaid Medicare

End-of-Year Compliance Deadlines and Reminders

Compliance Now

DECEMBER 20, 2022

The good faith transition relief that formerly shielded employers from penalties for incorrect and/or incomplete ACA filings is no longer available. Employers must successfully e-File complete, accurate ACA filings by this deadline or risk exposure to information return penalties and employer mandate penalties.

Compliance

Compliance COVID-19 ACA Governance

End-of-Year Compliance Deadlines and Reminders

Compliance Now

DECEMBER 20, 2022

The good faith transition relief that formerly shielded employers from penalties for incorrect and/or incomplete ACA filings is no longer available. Employers must successfully e-File complete, accurate ACA filings by this deadline or risk exposure to information return penalties and employer mandate penalties.

Compliance

Compliance COVID-19 ACA Governance

South Dakota Voters to Decide Medicaid Expansion

Kaiser Health News

JANUARY 6, 2022

Most states accepted the Medicaid expansion quickly after the ACA was implemented in 2014. For example, as of early last month, 210,000 people had enrolled in Oklahoma while Missouri had added fewer than 20,000, following expansions approved in 2020 in both states.

Medicaid

Medicaid Medicaid ACA Governance

Reflections on the United States Health Care System and the Right to Health

Bill of Health

NOVEMBER 9, 2023

Despite the important enactment in 2010 of the Patient Protection and Affordable Care Act (ACA), which increases access to care by expanding Medicaid eligibility and protecting insurance coverage of people with pre-existing health conditions and disabilities, more than 25 million people remain uninsured. First, while the U.S.

COVID-19

COVID-19 Public Health ACA Health Insurance

Computer glitches and human error still causing insurance headaches for Californians

Healthcare It News

JUNE 3, 2022

Legal aid attorneys, patient advocates, and insurance agents say computer glitches are not as common today as they were in the several years after California’s 2013 launch of ACA coverage. The exchange was new and millions of people were newly eligible for Medi-Cal.

Public Health

Public Health Health Insurance Professionals ACA Medicaid

Implications of Abortion Decision for Employee Benefit Plans

Compliance Now

JUNE 27, 2022

In a 2020 decision, the Supreme Court ruled that an Arkansas state law regulating pharmacy benefit managers was not preempted by ERISA because it did not govern “a central matter of plan administration or interfere with nationally uniform plan administration.” failure to comply with the ACA, COBRA, HIPAA, etc.). Other Considerations.

ACA

ACA HIPAA Governance Compliance

VBC: Improving Healthcare Outcomes With A Strong Payer-Provider Relationship

HIT Consultant

AUGUST 17, 2023

Years before the pandemic, the Affordable Care Act (ACA) revolutionized the healthcare industry and encouraged a new approach to balancing all the variables: value-based care (VBC). A 2022 American Medical Association study found that 63% of physicians had at least one instance of burnout in 2021, up from only 38% in 2020.

US Department of Health and Human Services

US Department of Health and Human Services Health Outcomes ACA Doctors

KFF Health News' 'What the Health?': Florida Limits Abortion — For Now

Kaiser Health News

APRIL 4, 2024

Menthol cigarettes are particularly popular in the Black community, and — like Trump’s decision as president to punt a ban on vaping to avoid alienating voters in 2020 — the Biden administration may be loath to raise the issue this year. Activists say, however, that it may be at the expense of Black lives.

Medicare

Medicare Medicare ACA Public Health

La atención de salud, en el centro del debate entre DeSantis y Newsom

Kaiser Health News

NOVEMBER 27, 2023

Esa política de gran alcance entra en vigencia en enero y va mucho más allá de la expansión opcional de Medicaid que la Ley de Cuidado de Salud a Bajo Precio (ACA) ofreció a los estados. Florida no cuenta con un mercado estatal, ni ofrece subsidios patrocinados por el estado.

COVID-19

COVID-19 ACA Medicaid Medicaid

The 3 A’s That Millennials Want From Healthcare: Affordability, Accessibility, Availability

Health Populi

MAY 15, 2019

The erosion of the Affordable Care Act, Obamacare health insurance marketplaces, and access to and availability of women’s preventive health provisions in the ACA has led to greater awareness among American women on the state of health insecurity. Another lens on this research are the implications for health policy and politics.

Health Insurance

Health Insurance ACA Doctors Hospitals

50 Days Before the U.S. Elections, Voters Say Health Care Costs and Access Top Their Health Concerns — More than COVID-19

Health Populi

SEPTEMBER 14, 2020

The pandemic has also led to economic decline that, seven weeks before the 2020 elections in America, is top-of-mind for health citizens with the virus-crisis itself receding to second place, according to the Kaiser Family Foundation September 2020 Health Tracking Poll. President in 2020. KFF polled 1,199 U.S.

COVID-19

COVID-19 Health Care Access ACA Public Health

Texas OIG Inspectors Discover Errors in Reported Nursing Home Staff Hours

Med-Net Compliance

NOVEMBER 8, 2022

Issue: In 2020, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) conducted a review of nursing facility staffing levels for 2018. The report revealed staffing levels varied considerably from day to day, which raised concerns some facilities may not fully meet the needs of their residents.

Nursing Homes

Nursing Homes Nurses US Department of Health and Human Services Licensing

Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

Health Populi

MARCH 11, 2021

These services are enumerated in Section 2713 in the ACA , prompting Dr. Kavita Patel to assert in the first panel of the day that, “2713 is my favorite number.” have struggled to pay for living expenses since December 2020, a year into the COVID-19 pandemic.

Health Insurance

Health Insurance ACA Medicare Medicare

The Economics of the Pandemic Put Costs at the Top of Americans’ Health Reform Priorities

Health Populi

MARCH 4, 2021

A major side-effect of the coronavirus pandemic in 2020 was its impact on the national U.S. economy, jobs, and peoples’ household finances — in particular, medical spending. A recent TraunsUnion study found that more younger than older Americans’ health care behaviors shifted in the public health crisis. population).

COVID-19

COVID-19 Health Insurance Patient Advocacy Public Health

At Cigna, telehealth reduces patient costs and ER visits, and boosts use of generic Rx

Healthcare IT News - Telehealth

NOVEMBER 20, 2019

“We currently reimburse behavioral health in-network providers for virtual care today and will expand this to all in-network providers in 2020,” McCarter noted. Extending this virtual care option to Cigna’s provider network. MARKETPLACE.

Telemedicine

Telemedicine ACA Licensing Doctors

Fifth Circuit Upholds ACA Risk Adjustment Program

Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. 1:18-CV-824-LY, 2020 WL 6380206, at *4 (W.D. United States Dep’t of Health & Hum.

ACA

ACA US Department of Health and Human Services Health Insurance Medicaid

What Will Expiration of the Public Health Emergency and National Emergency Mean for Employers?

Hall Render

MAY 2, 2023

As the COVID-19 pandemic took its toll, the year 2020 ushered in declarations of a National Emergency (“NE”) and a Public Health Emergency (“PHE”). The PHE is set to expire on May 11, 2023. In addition, H.J. 7 was signed by President Biden on April 10, which ends the NE on May 11, 2023 as well.

Public Health

Public Health COVID-19 COVID-19 Vaccine ACA

The Coronavirus Pandemic Turbocharged Digital Health Investment in 2020

Health Populi

OCTOBER 12, 2020

2020 will be remembered for disruption and dislocation on many fronts; among the major blips in the year will be it remembered as the largest funding year for digital health recorded, according to Rock Health’s report on the 3Q2020 digital health funding. In the third quarter of 2020, some $4 billion was invested in U.S.

COVID-19

COVID-19 ACA Public Health Doctors

More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Health Populi

NOVEMBER 19, 2019

This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. The summary’s title tells you the focus of the research: Mending Healthcare in America 2020 – Consumers + Costs.

Health Insurance

Health Insurance Hospitals Doctors Nurses

Only in America: The Loss of Health Insurance as a Toxic Financial Side Effect of the COVID-19 Pandemic

Health Populi

SEPTEMBER 17, 2020

households entered 2020 in the best financial shape they’d been in years, based on new Census data released earlier this week. By September 2020, about 36 million people in the U.S. In the Civis Analytics study, one-in-four Black Americans (26%) was uninsured by September 2020, up from 17% in February. In terms of income, U.S.

COVID-19

COVID-19 Health Insurance Public Health Health Care Access

Colorado abre período especial para tener seguro de salud por omicron y un incendio forestal

Kaiser Health News

JANUARY 20, 2022

. “Estas personas están tratando de rehacer sus vidas”, expresó Kevin Patterson, CEO de Connect for Health Colorado, el mercado de seguros de salud estatal, creado bajo la Ley de Cuidado de Salud a Bajo Precio (ACA). Pero esto cambió durante la pandemia.

COVID-19

COVID-19 ACA Public Health

The Economics of the Pandemic Put Costs at the Top of Americans’ Health Reform Priorities

Health Populi

MARCH 4, 2021

A major side-effect of the coronavirus pandemic in 2020 was its impact on the national U.S. economy, jobs, and peoples’ household finances — in particular, medical spending. A recent TransUnion study found that younger than older Americans’ health care behaviors shifted in the public health crisis. population).

COVID-19

COVID-19 Health Insurance Patient Advocacy Public Health

What’s Causing Fewer Primary Care Visits in the US?

Health Populi

FEBRUARY 5, 2020

The January 2020 Health Affairs published a paper on Primary Care Physicians’ Role in Coordinating Medical and Health-Related Social Needs in Eleven Countries. It’s important to call out the importance of primary care for any health reform plan that 2020 Presidential candidates are profferring.

Patient Advocacy

Patient Advocacy Health Insurance HIPAA Doctors

US Rep. Gaetz’s Diagnosis of What’s Driving Insulin Costs Misses the Root Cause

Kaiser Health News

APRIL 22, 2022

A 2020 study found that the list price of insulin products increased by 262% from 2007 to 2018, while a 2021 study found that from 2014 to 2018 the list price of insulin products increased by 40%. 7, 2019.

Pharmaceutical Industry

Pharmaceutical Industry ACA Health Care Reform Medicare

USA Today Finds Hidden Common Ground Among Americans For Health Care

Health Populi

FEBRUARY 7, 2020

In their study conducted in December 2020, U SA Today polled 1,020 adults age 18 and over in the USA TODAY/Public Agenda Hidden Common Ground Survey. This, above all, may be what solidifies the health care voters headed to the polls in November 2020. Thus far, the series has covered climate change, and this month health care.

Nurses

Nurses Doctors Governance Hospitals

CMS Includes MAOs in Data Exchange and Prior Authorization Requirements

Healthcare Law Blog

DECEMBER 15, 2022

The Proposed Rule would withdraw CMS’s December 18, 2020 Interoperability and Prior Authorization proposed rule , build on the policies finalized in the agency’s May 1, 2020 Interoperability and Patient Access final rule , and incorporate feedback CMS received from commenters on the December 2020 proposed rule.

Medicaid

Medicaid Medicaid Medicare Medicare

The Emergence of Health Citizens – Part of Liberating Health, on the Medecision Blog

Health Populi

SEPTEMBER 30, 2020

By sunset on 3rd November 2020, millions of U.S. . — people re-claiming their health, health care, and control of data — is part of liberating health in America. Please check out the post here , and let me know your thoughts.

Health Insurance

Health Insurance COVID-19 ACA

HHS Finalizes Health Plan Price Transparency Rule

C&M Health Law

NOVEMBER 23, 2020

On October 29, 2020, the Departments of Health and Human Services, Labor, and the Treasury (“the Departments”) issued a final rule requiring private-sector health insurers and self-insured health plans to disclose treatment prices and cost-sharing information with consumers. Responses to the final rule have been mixed.

Regulatory Compliance

Regulatory Compliance Hospitals Compliance Health Insurance

In the Past Ten Years, Workers’ Health Insurance Premiums Have Grown Much Faster Than Wages

Health Populi

OCTOBER 8, 2020

who benefits from health insurance at the workplace, the annual family premium will average $21,342 this year, according to the 2020 Employer Health Benefits Survey from the Kaiser Family Foundation. Over ten years, the premium dollars grew from $13,770 in 2010 to $21K in 2020. in 2020, as family premiums increased by 4.0%

Health Insurance

Health Insurance COVID-19 Telemedicine Public Health

The Cost of Health Care for a Family of 4 in America Will Reach $28,256 in 2021

Health Populi

JUNE 2, 2021

The good news for health care costs for a family of four in America is that they fell, for the first time in like, ever, in 2020. The first chart shows how health care costs declined in our Year of COVID, 2020, by over $1,000 for that hypothetical U.S. up, compared with the largest cost increase across categories in 2020 of 7.2%.

COVID-19

COVID-19 Health Insurance Health Outcomes Public Health

CMS Begins Option to Extend Medicaid Postpartum Coverage

Healthcare Law Blog

APRIL 6, 2022

Mothers with incomes up to 138% of the federal poverty level (“FPL”) in states which have expanded Medicaid under the Affordable Care Act (“ACA”) are eligible to remain covered by Medicaid and those with incomes above 138% FPL may be eligible to qualify for subsidized coverage through the ACA marketplace. 77-84 (2020). [5]

Medicaid

Medicaid Medicaid ACA Public Health

CMS Promotes Health Equity through Marketplace Standards and More in New Proposed Rule

Healthcare Law Blog

DECEMBER 11, 2023

Using enrollee-level data from the Enrollee-Level Data Gathering Environment (“ EDGE ”) server from 2019, 2020, and 2021 for recalibrating HHS risk adjustment models to ensure that the models accurately reflect the most current claims experience, contributing to market stability. Maintaining the 2.2% FFM user fee rate and 1.8%

Medicaid

Medicaid Medicaid ACA Medicare

Large Employers’ Focus on Prescription Drugs: Costs, Coupons and Communication

Health Populi

AUGUST 16, 2019

As large employers’ annual health care costs for an employee are expected to exceed $15,000 in 2020, companies are focusing in on managing the pharmacy line-item, we learn from the 2020 Large Employers’ Health Care Strategy and Plan Design Survey from the National Business Group on Health (NBGH).

Governance

Governance Health Care Reform FDA ACA

Health Provider News

Hall Render

MARCH 29, 2024

NATIONAL 14 Joint Commission patient safety goals for post-acute facilities 36 rural hospitals have closed since 2020 80% of nonprofit hospitals’ community investments lag their tax savings, Lown Institute finds AHA: There is Nothing ‘Fair’ about the Lown Institute’s ‘Fair Share’ Report AHA comments on draft Senate bill to clarify, protect 340B (..)

Nursing Homes

Nursing Homes US Department of Health and Human Services Nurses Hospitals

Health Provider News – August 19, 2022

Hall Render

AUGUST 19, 2022

Altru HERO Program Saves Patients Over $65 Million in 2020 and 2021. ACA health plan costs to drop sharply in Virginia. Alerus commits $1M to new Altru Health System hospital. COVID-19 hospitalizations, deaths up in North Dakota this week. Trinity Health provides Stroke Support Group. CDC warns of E. coli outbreak in Michigan and Ohio.

COVID-19

COVID-19 Nursing Homes US Department of Health and Human Services Nurses

Wasted: $1 of Every $4 Spent on Health Care In America

Health Populi

OCTOBER 8, 2019

Political debates in this 2020 U.S. health care system from reinvigorating the ACA/Obamacare (the Joe Biden approach), with a call for a public option and/or “Medicare for those who want it” in Buttigieg-speak; with Medicare-For-All the other end of the policy spectrum, supported explicitly by Bernie Sanders and Elizabeth Warren.

Prescription Drug Pricing

Prescription Drug Pricing Medicare Medicare ACA

Health Provider News – July 1, 2022

Hall Render

JULY 1, 2022

CMS approves first-ever public option plan for Colorado’s ACA exchange. Report shows Kentucky had second highest increase in deaths from alcohol, drugs and suicide in 2020. Colorado Springs long-term-care facility lays off 144 workers, relocates 79 residents amid challenges caused by pandemic. CONNECTICUT.

US Department of Health and Human Services

US Department of Health and Human Services COVID-19 Nurses Hospitals

ACA Reporting Deadline Extended and the End of “Good Faith” Compliance

Financial Health Is On Americans’ Minds Just Weeks Before the 2020 Elections

Trending Sources

Out-of-Pocket and Prescription Drug Costs – Connecting Digital Health Dots at CES 2020

Biden Administration Announces 2023 Out-of-Pocket Limits and PCORI Fee for the Upcoming Year

Medical Debt in the U.S. Greater in States That Did Not Expand Medicaid

The 2022 US Health System Report Card: Pretty Terrific If You Live in Hawaii or Massachusetts

U.S. Supreme Court Holds Healthcare Entities Not Liable for Emotional Injury Damages Under Certain Anti-Discrimination Statutes

End-of-Year Compliance Deadlines and Reminders

End-of-Year Compliance Deadlines and Reminders

South Dakota Voters to Decide Medicaid Expansion

Reflections on the United States Health Care System and the Right to Health

Computer glitches and human error still causing insurance headaches for Californians

Implications of Abortion Decision for Employee Benefit Plans

VBC: Improving Healthcare Outcomes With A Strong Payer-Provider Relationship

KFF Health News' 'What the Health?': Florida Limits Abortion — For Now

La atención de salud, en el centro del debate entre DeSantis y Newsom

The 3 A’s That Millennials Want From Healthcare: Affordability, Accessibility, Availability

50 Days Before the U.S. Elections, Voters Say Health Care Costs and Access Top Their Health Concerns — More than COVID-19

Texas OIG Inspectors Discover Errors in Reported Nursing Home Staff Hours

Value-Based Health Care Needs All Stakeholders at the Table – Especially the Patient

The Economics of the Pandemic Put Costs at the Top of Americans’ Health Reform Priorities

At Cigna, telehealth reduces patient costs and ER visits, and boosts use of generic Rx

Fifth Circuit Upholds ACA Risk Adjustment Program

What Will Expiration of the Public Health Emergency and National Emergency Mean for Employers?

The Coronavirus Pandemic Turbocharged Digital Health Investment in 2020

More Evidence of Self-Rationing as Patients Morph into Healthcare Payors

Only in America: The Loss of Health Insurance as a Toxic Financial Side Effect of the COVID-19 Pandemic

Colorado abre período especial para tener seguro de salud por omicron y un incendio forestal

The Economics of the Pandemic Put Costs at the Top of Americans’ Health Reform Priorities

What’s Causing Fewer Primary Care Visits in the US?

US Rep. Gaetz’s Diagnosis of What’s Driving Insulin Costs Misses the Root Cause

USA Today Finds Hidden Common Ground Among Americans For Health Care

CMS Includes MAOs in Data Exchange and Prior Authorization Requirements

The Emergence of Health Citizens – Part of Liberating Health, on the Medecision Blog

HHS Finalizes Health Plan Price Transparency Rule

In the Past Ten Years, Workers’ Health Insurance Premiums Have Grown Much Faster Than Wages

The Cost of Health Care for a Family of 4 in America Will Reach $28,256 in 2021

CMS Begins Option to Extend Medicaid Postpartum Coverage

CMS Promotes Health Equity through Marketplace Standards and More in New Proposed Rule

Large Employers’ Focus on Prescription Drugs: Costs, Coupons and Communication

Health Provider News

Health Provider News – August 19, 2022

Wasted: $1 of Every $4 Spent on Health Care In America

Health Provider News – July 1, 2022

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