Fierce Healthcare

OCTOBER 18, 2024

Oscar Health is expanding its reach in the individual market, and plans to offer coverage in 504 markets in 18 states for the 2025 plan year. Oscar Health is expanding its reach in the individual market, and plans to offer coverage in 504 markets in 18 states for the 2025 plan year.

ACA 98

ACA 98

HIT Consultant

APRIL 3, 2025

These shifts are partly due to Medicaid policy changes and Affordable Care Act (ACA) expansion. Conversely, median self-pay reimbursement as a percentage of gross patient revenue has declined from pre-pandemic levels, dropping to 2.0% in 2023 from 2.8% in 2019, excluding childrens hospitals, and to 1.8% for hospitals with early 2024 FYE.

Hospitals 59

Hospitals Medicaid Medicaid ACA 59

Healthcare Dive

NOVEMBER 16, 2023

Beginning in 2025, plans sold in state-based exchanges would be required to meet time and distance standards for provider access under a new rule proposed Wednesday.

ACA 176

ACA 176

Center for Health Insurance Reform

FEBRUARY 12, 2024

The Affordable Care Act (ACA) requires coverage of pediatric dental services in many commercial plans, but the law has had less of an impact on adult dental coverage. Dental care is an important element of comprehensive health care.

ACA 105

ACA 105

Healthcare Dive

FEBRUARY 4, 2025

The insurer also reported notable ACA growth for this year, though membership could tick back down through the second quarter due to program integrity efforts.

ACA 130

ACA 130

Fierce Healthcare

SEPTEMBER 5, 2024

Elevance Health subsidiary Wellpoint is debuting plans in three states for the 2025 coverage year. Elevance Health subsidiary WellPoint announced the company is debuting individual marketplace plans in Florida, Maryland and Texas.

ACA 119

ACA 119

Fierce Healthcare

APRIL 2, 2024

States now can add routine adult dental services as an essential health benefit, the Centers for Medicare & Medicaid Services announced in its 2025 Notice of Benefit and Payment Parameters fina | In its annual Notice of Benefit and Payment Parameters final rule, CMS prioritized dental and prescription drug benefits, network adequacy standardization (..)

ACA 110

ACA Medicaid Medicaid Medicare 110

Center for Health Insurance Reform

MARCH 24, 2025

On March 23, 2025, we celebrated the 15th anniversary of the Affordable Care Act (ACA). In this post, CHIR experts reflect on how the law's reforms affected people's access to affordable, high quality health insurance, and what the next 15 years might bring.

ACA 52

ACA Health Insurance 52

Healthcare IT Today

DECEMBER 4, 2024

With subsidies under the Affordable Care Act set to expire in 2025, he highlighted potential shifts in the insurance market based on the direction from the new incoming administration. If we can get them standardized that should help make the experience for all stakeholders more efficient and more valuable.”

Public Health 72

Public Health Governance ACA Hospitals 72

Health Populi

OCTOBER 14, 2024

the costs of health care and perceived ROI to employers (and employees bearing out-of-pocket financial skin in the game), the state of labor markets and availability of needed workers, and regulatory pressures that might shift prospects for industry in general or particular sectors in and beyond 2025.

Health Insurance 62

Health Insurance Prescription Drug Pricing COVID-19 Governance 62

Hall Render

JANUARY 10, 2025

On January 1, 2025, the Centers for Medicare and Medicaid Services’ (“CMS”) new 60-Day Rule became effective. 180-Day Suspension Period The ACAs initial enactment of the 60-Day Rule required reporting and returning of overpayments within 60 days of discovery.

Overpayments 40

Overpayments Overpayment ACA Medicare 40

American Medical Compliance

MARCH 13, 2025

Compliance of Section 1557 of the Affordable Care Act (ACA) reinforces this by prohibiting discrimination and holding healthcare providers accountable for fostering an inclusive environment. With July 5, 2025, fast approaching, healthcare organizations must act now to ensure compliance. Click here.

Compliance 59

Compliance ACA Patient Satisfaction Medicare 59

Center for Health Insurance Reform

MARCH 1, 2024

In November, the Biden administration released the proposed Notice of Benefits and Payment Parameters for plan year 2025, an annual rule setting standards for the Affordable Care Act (ACA) Marketplaces and health insurers.

ACA 98

ACA Health Insurance 98

Center for Health Insurance Reform

DECEMBER 18, 2023

Last month, the Biden administration proposed changes to Affordable Care Act (ACA) Marketplace policies and procedures. In a post for Health Affairs Forefront, Sabrina Corlette and Jason Levitis take a look at the proposals related to market reforms, Marketplace standards, and premium tax credits.

ACA 97

ACA 97

Healthcare Law Blog

AUGUST 25, 2022

Additional updates of note include: ACA Premium Tax Credit Eligibility. Essentially, the moratorium on the requirement that, to be eligible for a premium tax credit, household income must be at or below 400% of the federal poverty level, is extended through 2025. Other Updates. Catastrophic Phase Cost-Sharing. Out-of-Pocket Costs.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare Law Blog

DECEMBER 11, 2023

Reducing the risk adjustment user fee for 2025 from $0.21 1] These modifications are intended to further the Biden Administration’s goals of advancing health equity by addressing disparities in access to quality care while minimizing administrative burdens and ensuring program integrity. per member per month to reduce insurer costs.

Medicaid 52

Medicaid Medicaid ACA Medicare 52

Hall Render

JULY 8, 2024

Although Section 1557 took effect immediately upon the signing of the Affordable Care Act (“ACA”), a final rule was not promulgated until 2016 (the “2016 Rule”). Nondiscrimination in health insurance coverage and other health-related coverage (§ 92.207(b)(6)) By the first day of the first plan year beginning on or after January 1, 2025.

Health Insurance 40

Health Insurance Compliance Medicare Medicare 40

Healthcare Dive

JANUARY 21, 2025

million people signed up for Affordable Care Act plans during the open enrollment period for 2025, with huge increases in major Republican-led states.

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ACA 307

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 68

COVID-19 ACA Medicaid Medicaid 68

Hall Render

JANUARY 17, 2025

OrthoIndy to merge with Evansville, Fort Wayne practices St. healthcare fraud scheme New Orleans launches tool to help doctors find reproductive care drug amid tight state restrictions MAINE Owner of Woonsocket hospital expands into Maine St.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Compliance Now

OCTOBER 13, 2022

The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.

ACA 100

ACA Health Insurance Hospitals 100

Compliance Now

OCTOBER 13, 2022

The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.

ACA 100

ACA Health Insurance Hospitals 100

AIHC

AUGUST 13, 2024

Written by Corliss Collins , BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC and Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS The 2024 Final Rule for Section 1557 of the Affordable Care Act (ACA) was issued by the Department of Health and Human Services (HHS) on April 26, 2024.

Compliance 52

Compliance ACA Health Insurance Medicaid 52

Hall Render

JANUARY 10, 2025

A new state-sponsored group will help. UCHealth to use war medical tactic to help save lives in Northern Colorado New Northern Colorado program delivers whole blood to patients in the field CONNECTICUT $1.9

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

MAY 24, 2024

Chicago children’s hospital completes cyberattack recovery CommonSpirit posts $365M quarterly loss, -3.9%

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

NOVEMBER 27, 2023

11 Plan To Slash $1.5B Arthur M.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Jane Sarashon

FEBRUARY 19, 2025

To keep sharp on the topics, I attended Rx Market Insights: Performance Trends and Outlook for 2025, a data-rich session presented on February 18 by IQVIA and sponsored by Ascend Laboratories. The research was fielded between December 30, 2024 and January 7, 2025]. A poll conducted among 2,000 U.S.

ACA 59

ACA Doctors Medicaid Medicaid 59

Hall Render

JUNE 28, 2024

NATIONAL 50% of physicians are thinking of leaving the field due to shortage AHA backs bid to repeal nursing home staffing rule AHA wins lawsuit against HHS over third-party web tracking AHA responds to study blaming hospital prices for societal issues AHA slams study tying unemployment to hospital price increases Behind the battle against corporate (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Kaiser Health News

OCTOBER 8, 2024

En la mayoría de los estados, la temporada de inscripción abierta de la Ley de Cuidado de Salud a Bajo Precio (ACA) para los planes de salud comienza el 1 de noviembre y dura hasta el 15 de enero. Estamos en esa época del año otra vez. Aunque intenten parecer oficiales, no lo son.

ACA 72

ACA Health Care Reform Public Health 72

Hall Render

OCTOBER 27, 2023

Louis-based health system to form Michigan joint venture Mercy opens ‘high-tech’ multispecialty center, ASC in St. finds new C-suite exec at a subsidiary MONTANA COVID Map Shows Five States With ‘Substantial Increase’ in Hospital Admissions St.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes COVID-19 40

Kaiser Health News

OCTOBER 31, 2023

1 for the ACA’s federal and state exchanges. Health policy experts and brokers recommend all ACA policyholders at least look at next year’s options, because prices — and the doctors and hospitals in plans’ networks — may have changed. It Could Be Another Record Year ACA plans are now well entrenched — an estimated 16.3

ACA 123

ACA Health Insurance Medicaid Medicaid 123

Kaiser Health News

OCTOBER 31, 2023

Para millones de personas que compran su propio seguro de salud a través del mercado establecido por la Ley de Cuidado de Salud a Bajo Precio (ACA, popularmente conocida como Obamacare), el final del año trae un ajuste de cuentas: es el momento de comparar beneficios y precios, cambiar a un nuevo plan o inscribirse por primera vez.

ACA 64

ACA Medicaid Medicaid COVID-19 64

Kaiser Health News

JULY 24, 2024

Often, consumers who are targeted don’t know they’ve been enrolled or that their coverage has been switched to a new plan until they lose access to preferred doctors, learn they have different deductibles, or find they owe taxes for ACA insurance premium subsidies.

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ACA Health Insurance Patient Advocacy Fraud 136

Hall Render

JUNE 16, 2023

Artificial Intelligence Poses Threat to Patient Privacy Bill for Rural Hospital Cyber Skills Passes Senate Committee Chemotherapy shortages push cancer centers toward crisis CMS estimates national spending on hospital care grew just 0.8% before Baptist merger Bankruptcy Trustee Wants Doctor To Pay Her $1.6M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Kaiser Health News

DECEMBER 6, 2023

It’s likely one of the last major ACA policy efforts of President Joe Biden’s first term — and, if he loses reelection, could represent his final touches on the landmark health program created when he was vice president. In part because of those subsidies, enrollment has increased steadily and hit records under his watch.

Doctors 102

Doctors ACA Hospitals Health Insurance 102

Bill of Health

DECEMBER 7, 2024

For many Americans, the Affordable Care Act (ACA) has been a crucial piece of that safety net, providing access to affordable health care, expanded coverage options, and support for innovative medical care delivery methods that lower health care costs.

ACA 185

ACA Medicaid Medicaid Health Care Reform 185

Bill of Health

DECEMBER 7, 2024

For many Americans, the Affordable Care Act (ACA) has been a crucial piece of that safety net, providing access to affordable health care, expanded coverage options, and support for innovative medical care delivery methods that lower health care costs.

ACA 130

ACA Medicaid Medicaid Health Care Reform 130