Compliance Now

AUGUST 28, 2023

By: David Mordo, Senior Compliance Consultant, MZQ Consulting The IRS recently released Revenue Procedure 2023-29 , which declared that the Affordable Care Act (ACA) benchmark for determining the affordability of employer-sponsored health coverage will significantly decrease to 8.39% of an employee’s household income for the 2024 plan year.

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Fierce Healthcare

DECEMBER 12, 2022

CMS proposes cap on non-standard ACA plans, network adequacy standard changes for 2024. Mon, 12/12/2022 - 17:34.

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Fierce Healthcare

MAY 9, 2023

CEO Mark Bertolini: Oscar Health to exit California's ACA exchange in 2024 fdiamond Tue, 05/09/2023 - 18:16

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Fierce Healthcare

JULY 25, 2024

Payer Roundup— Molina's $350M purchase; Democrats look to punish fraudulent ACA brokers; Centene sells Florida subsidiary ntong Thu, 07/25/2024 - 14:28

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Fierce Healthcare

SEPTEMBER 11, 2023

At a time when inflation seems to be on the nation’s radar, it’s no surprise that Blue Cross and Blue Shield of North Carolina would tout that members in the healthcare plans it offers in the Affor | The rate decrease, approved by the North Carolina Department of Insurance, will lower total premiums by an estimated $130 million for enrollees in the (..)

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Center for Health Insurance Reform

APRIL 29, 2025

A new CHIR report offers a snapshot of the dental coverage landscape on the ACA Marketplaces in 2025. In this analysis, CHIR experts present insights into why stand alone dental plan uptake remains limited and what state-specific policy decisions could mean for future dental coverage options.

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HIT Consultant

APRIL 3, 2025

What You Should Know: – Fitch Ratings has released a report revealing an improvement in the median financial performance of Fitch-rated not-for-profit (NFP) hospitals and healthcare systems with early fiscal year ends (FYE) in 2024, compared to the previous year. for hospitals with early 2024 FYE. reported in CY2023.

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Compliance Now

DECEMBER 22, 2022

The Department of Health and Human Services has announced the new out-of-pocket (OOP) limits that will apply to group and individual health plans during the 2024 plan year. 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.

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Compliance Now

DECEMBER 22, 2022

The Department of Health and Human Services has announced the new out-of-pocket (OOP) limits that will apply to group and individual health plans during the 2024 plan year. 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.

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Center for Health Insurance Reform

OCTOBER 19, 2023

The annual open enrollment period for Affordable Care Act (ACA) Marketplace coverage kicks off November 1 in most states.

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Health Populi

OCTOBER 14, 2024

The premium for employer-sponsored health plans grew by 6-7% between 2023 and 2024, according to the report on Employer Health Benefits 2024 Annual Survey from the Kaiser Family Foundation, KFF’s 26th annual study into U.S. In 2024, 54% of all firms offered some health benefits, stable with 2023’s offer rate.

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Fierce Healthcare

OCTOBER 12, 2023

Oscar Health will expand its footprint on the Affordable Care Act exchanges into 165 new counties for 2024, the insurtech announced Thursday.

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Center for Health Insurance Reform

MARCH 31, 2023

The Affordable Care Act (ACA) recently celebrated its 13th anniversary with historic enrollment growth in the health insurance Marketplaces and the lowest-ever recorded uninsured rate. Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: Health Insurers

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Fierce Healthcare

FEBRUARY 8, 2024

Enrollment in individual market plans continues to grow, with a record high of 21.3 million people signing up for plans during the most recent open enrollment period. | CEO Mark Bertolini told investors that Oscar “closed out 2023 with another strong quarter, driving financial performance for the full year.”

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Fierce Healthcare

AUGUST 25, 2023

Cigna is cutting down its Affordable Care Act exchange footprint down to 14 states, the company said Monday. Cigna is cutting down its Affordable Care Act exchange footprint down to 14 states, the company said Monday.

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Kaiser Health News

JANUARY 12, 2024

The ACA also includes subsidies that offset all or part of the premium costs for the majority of low- to moderate-income people who seek to buy their own insurance. Those subsidies are one of the reasons cited for record enrollment in 2024 plans , with more than 20 million people signing up so far. And even with insurance, many U.S.

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Center for Health Insurance Reform

DECEMBER 15, 2023

As 2023 comes to a close, it’s time to think about health insurance for 2024. Consumers searching for a 2024 plan online may come across products that do not have to comply with the Affordable Care Act's (ACA) consumer protections.

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Compliance Now

OCTOBER 10, 2023

For the 2023 ACA filing and beyond, employers that cumulatively submit at least ten forms to the IRS, including W-2s, 1099s, ACA Forms 1094/1095, and other common form series, must file all of those forms electronically. Ultimately, the ten-form aggregate threshold will necessitate electronic filing for nearly every employer.

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Compliance Now

OCTOBER 10, 2023

For the 2023 ACA filing and beyond, employers that cumulatively submit at least ten forms to the IRS, including W-2s, 1099s, ACA Forms 1094/1095, and other common form series, must file all of those forms electronically. Ultimately, the ten-form aggregate threshold will necessitate electronic filing for nearly every employer.

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Center for Health Insurance Reform

JUNE 24, 2024

The Congressional Budget Office (CBO) projects that the all-time-high rate of insurance coverage in 2023 represents a peak, and significant numbers of people will become uninsured between 2024 and 2034. However, these projections are not our destiny.

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Healthcare IT Today

DECEMBER 4, 2024

The ban has been opposed by ACA International, Healthcare Financial Management Association, Medical Group Management Association, and the American Hospital Association. It is important to note that these proposed changes were provided first by the CFPB after convening an SBREFA panel in 2023 and without any input from healthcare providers.

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HIT Consultant

JANUARY 2, 2025

The ban has been opposed by ACA International, the Healthcare Financial Management Association (HFMA), the Medical Group Management Association (MGMA), and the American Hospital Association (AHA).

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Center for Health Insurance Reform

OCTOBER 21, 2024

The Affordable Care Act (ACA) marketplaces have become vital lifelines for millions, especially for communities of color, significantly reducing the uninsured rate and expanding access to affordable coverage.

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Health Populi

JUNE 30, 2023

in 2024, according to the annual report from the PwC Health Research Institute, Medical cost trend: Behind the numbers 2024. for 2024 medical trend. The post The Cost of Treating Patients is On the Rise: PwC Goes What’s Behind the 2024 Medical Spending Numbers appeared first on HealthPopuli.com.

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Compliance Now

JULY 14, 2023

By Jessica Waltman Late last week, the Departments of Health and Human Services, Labor, and Treasury (the Departments) published a set of FAQs that clarify how certain surprise billing protections interact with the Affordable Care Act’s (ACA) maximum out-of-pocket limit (OOP) requirements.

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Compliance Now

JULY 14, 2023

By Jessica Waltman Late last week, the Departments of Health and Human Services, Labor, and Treasury (the Departments) published a set of FAQs that clarify how certain surprise billing protections interact with the Affordable Care Act’s (ACA) maximum out-of-pocket limit (OOP) requirements.

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Jane Sarashon

FEBRUARY 27, 2024

While the digital health stakeholder community is convening this week at VIVE in Los Angeles to share innovations in health tech, NABIP has assembled health insurance leaders in Washington, DC, for the 2024 Capital Conference to focus on major health reform issues that are top-of-mind for health care payors — which in today’s U.S.

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Healthcare IT Today

JANUARY 16, 2025

This strategic investment comes on the heels of Scriptas revenue surging more than 100% in 2024, capping a milestone year for the business. As of September 30, 2024, Aquiline has approximately $11.3 As of September 30, 2024, Aquiline has approximately $11.3 Originally announced December 18th, 2024

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Fierce Healthcare

FEBRUARY 25, 2024

One of the most powerful components of the Affordable Care Act (ACA) was the mandate that nonprofit hospitals provide an income-based financial assistance program.

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Fierce Healthcare

FEBRUARY 22, 2024

Below is a roundup of payer-centric news for the week of Feb.19, This week, voters said they are worried about insurance premium costs in a new poll, Cigna invests nearly $10 million in 9amHealth, Waltz Health enters the Medicare market and more.

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Healthcare IT Today

FEBRUARY 21, 2024

Based in Chicago with 160 professionals, HealthScape helps payers across all segments, including commercial, Medicare, Medicaid, ACA, and federal, navigate the evolving healthcare landscape. Originally announced February 6th, 2024

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Healthcare IT Today

DECEMBER 4, 2024

Healthcare IT Today jumped at the opportunity for an exclusive sit-down interview with Musser at the 2024 NCQA Health Innovation Summit that was held in Nashville, TN. As such, they are uniquely positioned to both influence policymakers and help the healthcare industry adapt to policy changes.

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HIT Consultant

JULY 25, 2024

Recent US legislation has made comprehensive testing essential for companies aiming to release new AI-based products and services: – The ACA Section 1557 Final Rule, effective June 2024, prohibits discrimination in medical AI algorithms based on race, color, national origin, gender, age, or disability.

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Bill of Health

SEPTEMBER 21, 2024

One such effort is a recent suit challenging HHS rules under ACA section 1557 and its prohibition against discrimination in health care. The Affordable Care Act is always a target for litigation (roughly 2,000 lawsuits since 2010). HHS policies will no doubt be challenged under Loper Bright.

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MedTrainer

MAY 10, 2024

This process is vital for enhancing the accessibility and affordability of mental health services, aligning with the comprehensive healthcare coverage expansions under the Affordable Care Act ( ACA ). Credentialing confirms the providers’ eligibility to bill for services under government and accreditation regulations. Effective Jan.

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Compliancy Group

FEBRUARY 12, 2024

Pharmacy Fraud and Kickback Scheme In early February 2024, the co-owner and the administrator of a New Jersey pharmacy admitted to defrauding insurance providers, including Medicare and Medicaid. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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HIT Consultant

JUNE 5, 2024

The Affordable Care Act of 2010 (ACA) and the Medicare Access and CHIP Reauthorization Act of 2015 put providers on notice that quality of care measures, like reducing hospital readmissions and improving patient outcomes, would take precedence over fee-for-service models.

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