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Health Insurance Report

Health Insurance Report™ helps you track and analyze legal, legislative, and regulatory developments affecting the health-insurance industry throughout implementation of the Affordable Care Act and the insurance exchanges.

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EXPERT NEWS & COMMENTARY

Keep on top of new federal regulations from the Department of Health and Human Services as well as the Center for Consumer Information and Insurance Oversight under the Centers for Medicare & Medicaid Services. Learn first of the latest insurance industry developments, trends, mergers and acquisitions, studies on health care and insurance costs, new benefit plan designs, HMOs, pharmacy benefits, health care technology costs and innovations, and other private sector developments.


TRUSTED LEGAL ANALYSIS

Read expert reports on the establishment of state health insurance exchanges, legislation, and regulations that affect health insurance companies, and actions taken by state insurance departments and the National Association of Insurance Commissioners to regulate insurance coverage and delivery.

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SPECIAL FEATURES

Access HealthDocs™, Bloomberg BNA's full-text collection of key documents related to the impact of the Patient Protection and Affordable Care Act of 2010 on the availability and regulation of health insurance.

Use a comprehensivehealth reform implementation timeline to chart the various deadlines for reforms to insurance coverage, Medicare, Medicaid, the health care delivery system, provider and plan payments, financing, and compliance and transparency requirements from 2010 through 2020.


TOPICS COVERED

  • Access
  • Advertising and marketing
  • Antitrust
  • Consumer satisfaction
  • Costs
  • Coverage
  • Employee benefits
  • Financing
  • Fraud and abuse
  • HMOs
  • Information technology
  • Health-insurance exchanges
  • Insurance-industry trends
  • Insurance regulation
  • Medicare Advantage, Part D
Key Laws and Regulations
  • Affordable Care Act
  • CMS, DOL, and IRS regulations implementing health reform
  • National Association of Insurance Commissioners Model Regulations
  • State health insurance regulations

SPECIFICATIONS

Product Structure

Notification: current reports providing news and developments.

Formats and Frequency

Web notification, including a PDF and e-mail summary, is available weekly.

Email alerts are sent to subscribers as often as needed and whenever significant new documents are issued. Archive (Health Plan & Provider Report back issues) dates to 01.07.1998.

 


RECENT HEADLINES

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Obama Administration Issues Final Rules On Limited Wraparound Coverage Under ACA
March 18
16.4M Adults Gained Coverage Under ACA, HHS Report Says
March 18
Administration Highlights ACA Special Enrollment for Tax Filers
March 18
HealthCare.gov CEO Tells Insurers To Submit Risk Adjustment Data
March 18
HHS Releases Breakdown of Enrollment In Affordable Care Act Exchanges
March 18
CMS Unveils New ACO Model With More Financial Risk, More Shared Savings
March 18
Bipartisan House Group Asks CMS Not to Cut Pay to Medicare Advantage Plans
March 18
MedPAC Report to Congress Cites Growth in Medicare Advantage Plans
March 18
CBO Says President Obama's Budget Has Net Medicare Cut of $240 Billion
March 18
1.1M Children Would Lose Coverage Without CHIP Extension, MACPAC Reports
March 18
Oregon Failed to Collect $3 Million In Medicaid Drug Rebates in 2010, OIG Says
March 18
PCORI Has Awarded Over $670M To Fund Research, GAO Finds
March 18
IRS Issues Two Health Care-Related Publications
March 18
CMS HPMS MEMORANDA
March 18
Fifth Circuit Makes It Easier for Hospitals To Sue Insurers, Follows Ninth Circuit, DOL
March 18
Agency Interpretative Changes Don't Require Rulemaking, Unanimous Supreme Court Says
March 18
Court OKs Lien on Injury Settlement, Denies Application of ‘Make-Whole' Doctrine
March 18
IPAB Challengers Maintain Issue Is Ripe In Reply to Government Opposition Brief
March 18
Court: Insurer and Union Not Liable For Hostess's Cancellation of Insurance
March 18
Two Southern California Residents Guilty In $50M Health Insurance Fraud Scheme
March 18
Eleven Charged in Identity Theft, Fraud Conspiracy Involving Michigan Blues
March 18
New York Insurer Pays $400,000 to Cover Anesthesiology Services in Colonoscopies
March 18
Prime Healthcare Drops Offer to Buy Hospitals, Says Conditions Too Tough
March 18
Senate Panel OKs Medicaid Alternative, But Lawmakers See Tough Path for Passage
March 18
Extended Enrollment Period Allowed More Marylanders to Obtain Coverage
March 18
House Scuttles Governor's Proposal To Expand Medicaid to 70,000 People
March 18
Utah Legislature Fails to Expand Medicaid; Governor Forms Group to Reach Compromise
March 18
Uncompensated Care Legislation To Become Law Without Governor's OK
March 18
State Regulations for Alaska, Alabama, California, Colorado, Kentucky, Maryland, Massachusetts, Texas and Virginia
March 18
Pfizer Executive Suggests ‘Creative’ Financing for Costly Drugs
March 18
Employers Should Consider Several Measures To Comply With ACA Reporting, Speaker Says
March 18
Drug Costs Grew Last Year At Fastest Rate in Decade, Report Says
March 18
Alternative Way to Pay for Expensive New Drugs May Be Needed, RAND Says
March 18
Drugmakers Turn Heat on Insurers by Backing Copay Limits in States
March 18
Proposed Rates, Policy Changes in Notice Lauded, Panned by MA, Part D Stakeholders
March 18
CONFERENCES
March 18
HHS Official Says Some Enrollees Not Getting Correct 2015 Subsidies
March 4
More Than 8.8M Enrolled in ACA Coverage Through Federal Marketplace for 2015
March 4
Final Rule Implements Medicare Secondary Payer Law
March 4
CMS Extends Good-Faith Safe Harbor To 2015 for Noncompliant Health Plans
March 4
Actuaries Call for Rate Revisions If Federal ACA Subsidies Overturned
March 4
House Republicans Outline Alternative to ACA in WSJ Op-Ed
March 4
OIG: Insurance Marketplaces a Focus Area For Upcoming Affordable Care Act Reviews
March 4
Integrated Care May Be Incompatible With ACA System, Speaker Says
March 4
CMS Official Questions How Much Coordination Needed Among Payers
March 4
OIG Won't Sanction Hospital Network For Discounts Offered to Medigap Plan
March 4
IRS Notice on ‘Cadillac' Tax Gives Indication of Intention, Asks for Collaboration
March 4
No Plan in Place Should Supreme Court Strike Down ACA Subsidies, Burwell Says
March 4
Burwell Unaware of Document on Plans If High Court Rules Against ACA Subsidies
March 4
HHS Focusing on Improving ‘Back End' of HealthCare.gov
March 4
Taxpayers Who Filed Based on Wrong ACA Data Won't Owe U.S.
March 4
CMS Official Says New ACO Model May Be Unveiled in March
March 4
Congressional Republicans Tell Obama MA Cuts Will Limit Beneficiary Choices
March 4
DOJ Official Offers Enforcement Insight At Health-Care Competition Workshop
March 4
CMS Clarifies Use of ICD-9 Codes for Some Claims Submitted After Conversion Deadline
March 4
DOL Seeks to Extend Two ACA-Related ICRs
March 4
Filing Deadline Extended for Farmers, Fishermen
March 4
CMS HPMS MEMORANDA
March 4
2nd Cir. Requests Briefing in Parity Act Case, Seeks Opinion on Effect of Recent Precedent
March 4
Government Says Case Challenging IPAB Not Ripe for Resolution, in High Court Brief
March 4
Insurance Firms Must Defend Claims That They Boycotted Surgical Centers
March 4
Judge: Hi-Lex Not Automatic Path to Victory For Companies Suing BCBSM Over Fees
March 4
Maine Tells Supreme Court That Government Can't Require It to Maintain Age Extension
March 4
Man Denied Coverage for Cancer Procedure Stated Breach of Insurance Contract Claim
March 4
NAIC Announces Seven States Leading Examination of Anthem Cyberattack
March 4
Attorney General OKs Conditional Sale Of Nonprofit Hospitals to For-Profit Purchaser
March 4
Special Enrollment Period Benefits Those Facing Tax Penalty for Being Uninsured
March 4
Preliminary Numbers Show State Fell Short on Exchange Private Plan Goal
March 4
Iowa Chiropractors Fail to State Per Se Claim Against Wellmark
March 4
House Speaker Vows to Block Vote On Governor's Medicaid Expansion Plan
March 4
Law Allows Ending Risk-Pool Coverage For People With Access to ACA Coverage
March 4
Legislature Clears Bill Expanding Breach Notice, ID Theft Laws to Health Data
March 4
Congressional Employees Can Buy Insurance On D.C. Small Business Exchange, Court Says
March 4
Governor Proposes Some Health Cuts, Keeps Current Funding Level for Hospitals
March 4
State Regulations for California, Georgia, Kansas, Massachusetts, Missouri, Texas, Utah and Virginia
March 4
FBI Says It Is Close to Discovering Hackers in Anthem Health-Care Data Theft
March 4
Anthem Hack May Have Involved Millions Who Aren't Customers
March 4
Massive Data Breaches Fuel Pressure To Fortify Security Practices, Attorney Says
March 4
Drug Breakthroughs Stir Payer Pushback at $5,000 a Month and Up
March 4
Second Year of ACA Has Good Sign-Ups but More Market Information Needed
March 4
ACA's Survival Hangs on Four Words at U.S. High Court: Q & A
March 4
Stakeholders See Range of Impacts From MA Rate Proposal but No Dramatic Change
March 4
OIG Report, ‘Health Reform Oversight Plan Fiscal: Year 2015' (2/25/15)
March 4
80 FR 10750, 02/27/2015—CMS Final Rule on Notice of 2016 Benefit and Payment Parameters for ACA Insurance Exchanges
March 4
IRS Notice 2015-16 on Excise Tax on High-Cost Employer-Sponsored Health Plans (2/23/15)
March 4
CONFERENCES
March 4
HHS Releases Wide-Ranging Final Rule On Requirements for 2016 Exchanges
February 25
Special ACA Enrollment Period Allowed; Updated Tax Form Being Resent to 800,000
February 25
Most Who Received ACA Subsidies Must Repay a Portion of Them, H&R Block Finds
February 25
Burwell Says 2015 ACA Sign-Ups On Track To Meet Goal of 9.1 Million Paid Enrollees
February 25
CMS Says MA Plans Should Expect About a 1 Percent Increase in 2016
February 25
OPM Issues Multi-State Plan Rule As Program Expands to 36 States
February 25
IRS Issues Initial ‘Cadillac' Tax Guidance, Welcomes Comments on Various Topics
February 25
Business Groups Want Delay In Small Group Market Expansion
February 25
CMS Outlines Methodology to Determine 2016 Payments Under Basic Health Program
February 25
Report Finds Decreased MA Funding Led to Drop in Value of Plan Benefits
February 25
CMS Introduces New Program Audit Areas Focusing on Medication, Network Adequacy
February 25
Congressional Republicans Ask Governors For Input on Health-Care Proposal
February 25
IRS Provides Relief for Small Employers Providing Employer Payment Plans
February 25
Senate Republicans Introduce Anti-ACA, Health-Care Extender Bills
February 25
IRS Refines Rules for Exclusion From $100B Health Insurers Fee
February 25
ACA Proving Not a Burden To U.S. From Chipotle to Wal-Mart
February 25
Patrick Conway to Become Acting Principal Deputy Administrator of CMS
February 25
FTC, DOJ Release Agenda for Joint U.S. Health-Care Competition Workshop
February 25
CMS HPMS MEMORANDA
February 25
Anthem Should Return Part of Premiums Due to Customer Data Breach, Lawsuit Says
February 25
DOJ Asks Humana to Hand Over Medicare Advantage Data, Risk Policies
February 25
11th Circuit Won't Reconsider Dismissal Of Case Challenging Employer Mandate Delay
February 25
HHS's ‘Term of Art' Argument Has No Basis In Law, Common Sense, Plaintiffs Tell Court
February 25
High Court Won't Hear Doctors' Challenge To Contempt Finding in Antitrust Lawsuit
February 25
ERISA Preempts Provider's Claims For Lack of Payment, Ninth Circuit Rules
February 25
High Court Denies Cert in Preemption Case, Won't Address Anti-Subrogation Circuit Split
February 25
ERISA-Based Equitable Lien Dispute Won't Be Heard by U.S. Supreme Court
February 25
Covered California Expects Over 500,000 New Enrollees in Second Year by Feb. 22
February 25
Sign-Ups in State Exchanges Stagnate, But Surge in States Using HealthCare.gov
February 25
Governor's Plan for $1.5B in Medicaid Cuts Criticized by Hospital Association, Democrats
February 25
Democratic Lawmakers Urge Gov. Walker To Adopt Iowa's Medicaid Expansion Model
February 25
Medicaid Expansion Costs Offset By Savings, New Revenue, Study Finds
February 25
Wyoming House Defeats Latest Attempt to Expand Medicaid
February 25
Gov. Hogan Softens Tone on Exchange As Enrollment Season Ends Successfully
February 25
Report Says New York Medicaid Failed to Maximize Available Drug Rebates
February 25
State Regulations for Colorado, Kansas, Maryland and Oregon
February 25
Managing Business Associates a Challenge For HIPAA-Covered Entities, Attorney Says
February 25
ACA Increasing Many Companies' Focus On Wellness Programs, IFEBP Survey Finds
February 25
Aetna Signs Pact to Offer Prevention Plans Based on Genes, Behavior to Improve Health
February 25
View From Groom: DOL and HHS Enforcement Activities Targeting Health Plans and Insurers
February 25
CMS Fact Sheet on Basic Health Program Funding Methodology Final Notice (2/19/15)
February 25
IRS Notice 2015-17 on ACA Penalty Relief for Small Employers (2/18/15)
February 25
CCIIO Final 2016 Letter to Issuers in the Federally-facilitated Marketplaces (2/20/15)
February 25
CMS Fact Sheet, ‘Moving Medicare Advantage and Part D Forward’ (2/20/15)
February 25
CMS Fact Sheet on Final HHS Notice of Benefit and Payment Parameters for 2016 (2/20/15)
February 25
80 FR 9649, 02/24/2015—OPM Final Rule Establishing Multi-State Plan Program for the Affordable Insurance Exchanges (2/24/15)
February 25
80 FR 9636, 02/24/2015—CMS Final Notice on Federal Funding Methodology Under Basic Health Program for Program Year 2016 (2/24/15)
February 25
CMS Advance Notice of Methodological Changes for Calendar Year (CY) 2016 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2016 Call Letter (2/20/15)
February 25
CONFERENCES
February 25
CMS Extends Enrollment Deadline For Enrollees Who Had Technical Problems
February 18
Extra ACA Sign-Up Time Mulled To Help Taxpayers Avoid Fines
February 18
Data Analysts Say Third-Party Tracking on HealthCare.gov Excessive
February 18
House Republicans Won't Fix ACA On Subsidies, Rep. Ryan Says
February 18
As Open Enrollment Deadline Nears, HHS Reports 10 Million ACA Sign-Ups
February 18
Lawmakers Introduce Bill to Repeal ACA's Health Insurance Tax
February 18
Rule Includes OIG Recommendations On Disenrolling Ineligible Plan Enrollees
February 18
HHS Officials Defend Federal Programs for Serious Mental Illness
February 18
Union Plans Need to Look Ahead To Cadillac Tax Despite Lack of Guidance
February 18
Panelists Praise Medicare Advantage As Having Positive Impact on Medicare
February 18
Lawmakers Split Over Merits of ICD-10 Implementation, Impact on Health Industry
February 18
Medicare, Medicaid Remain Among Government's High-Risk Programs
February 18
IRS Posts ACA Reporting Requirement Publication
February 18
CMS HPMS MEMORANDA
February 18
St. Luke's Must Divest Physician Group Despite ‘Efficiencies,' Appeals Court Rules
February 18
Coverage Accommodation Doesn't Burden Religious Nonprofit Groups, 3rd Cir. Says
February 18
California Surgical Center May Not Enforce Alleged Oral Contract With Insurance Carrier
February 18
Judge Enforces Anti-Assignment Clauses, Denies Providers' Claims Against Blue Shield
February 18
AstraZeneca Pays $7.9M to Resolve Pharmacy Benefit Kickback Allegations
February 18
State Regulations for Alabama, Connecticut, Indiana, Michigan, Nebraska, Oklahoma, Rhode Island and Utah
February 18
Attorneys General Call for Anthem Response; Company Agrees to Offer Protections
February 18
New York Regulators Call on Insurers To Do More to Protect Against Cyberthreats
February 18
HSA Assets Rose 29 Percent in 2014, Report Says
February 18
Anthem Data Breach Focuses Attention on Role Benefit Plan Fiduciaries Play in Managing & Controlling Plan Records
February 18
MA, Part D Industry Active as Advance Notice on Rates, Policy Approaches
February 18
ASPE Research Brief: ‘Health Insurance Marketplace 2015: Average Premiums After Advance Premium Tax Credits Through January 30 in 37 States Using the HealthCare.gov Platform' (2/9/15)
February 18
80 FR 7912, 02/12/2015—CMS Final Rule on Contract Year 2016 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (2/12/15)
February 18
CRS Report, ‘Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act' (2/9/15)
February 18
IRS Publication 5196, ‘Affordable Care Act: Reporting Requirements for Applicable Large Employers' (Posted 2/9/15)
February 18
CONFERENCES
February 18
Democrats Say Raising ACA Hourly Coverage Threshold Increases Cutbacks
January 28
Advocacy Groups Want Federal Minimum Standards for ACA ‘Essential Health Benefits'
January 28
IRS Offers Relief From Penalties Related To Early Payments of ACA Premium Credit
January 28
CMS Clarifies Marketing Requirements For Medicaid Managed Care Plans
January 28
CMS Failed to Ensure HealthCare.gov Contracts Were Awarded Properly, OIG Says
January 28
Another Insurer Limits Patients' Expenses for HIV/AIDS Drugs in Florida
January 28
CBO Lowers Cost of ACA Coverage Provisions $100 Billion Compared With 2014
January 28
IRS Finalizes Broad Tax Exemption Requirements for Health Care CO-OPs
January 28
Roskam Questions IRS Decision to Hire IT Firm Linked to HealthCare.gov Website
January 28
Hatch, Alexander Among Sponsors Of Bill to Repeal Individual Mandate
January 28
Providers Faced With Too Much Risk When Setting Up ACOs, Lawmaker Says
January 28
Hatch Outlines Finance Committee Priorities, Says SGR, CHIP ‘Must Pass' Items
January 28
Medicaid Advisers Plot Future of CHIP Coverage as Funding Set to Expire
January 28
DOJ, FTC Will Hold Late February Workshop on Health-Care Competition
January 28
DOL Posts ERISA Advisory Council Reports
January 28
CMS HPMS MEMORANDA
January 28
Government Responds to IRS Rule Challenge, Says Overturning Rule Could Be ‘Disastrous'
January 28
Supreme Court Won't Review State's Case Challenging IRS Exchange Subsidy Rule
January 28
2nd Circuit: Judge Must Reconsider $2 Million in Disputed Medical Claims
January 28
Government Says Notre Dame Isn't Entitled To Vacatur of 7th Cir. Decision on Mandate
January 28
Supreme Court Paves Way for Employers To Reduce Union Retiree Health Benefits
January 28
Court: Baltimore Schools' Notice Failure To Suspended Employees Violated COBRA
January 28
District Court Refuses to Dismiss Out-of-Network Providers' Antitrust Claims
January 28
Free Perks to Medicare Plan Beneficiaries Disclosed Previously, FCA Dismissal Affirmed
January 28
Judge Denies Plan's Reimbursement Action; Plan Can't Recover From Wrongful Death Suit
January 28
New Arkansas Governor, ACA Foe, Says State Should Keep Medicaid Expansion
January 28
Shuttered Health Plan Preparing Initial Payouts, Won't Pay All $8M in Claims Owed
January 28
Covered California Affirms Policy Limiting New Insurers' Entry to Exchange Until 2017
January 28
Governor Unveils Medicaid Expansion Plan Modeled After State's Program for Children
January 28
State to Move More Medicaid Enrollees To Private Plans in Modernization Initiative
January 28
Report Suggests Options for Replacing Expiring $1.3B Hospital Funding Program
January 28
ACA Plans in 31 States Don't Cover Abortion
January 28
N.H. Insurance Commissioner Leads NAIC Committee
January 28
State Regulations for Idaho, Illinois, Nevada, Ohio, Oregon, Texas and Wyoming
January 28
BCBSA Study Finds Wide Variation In Costs for Knee, Hip Replacement
January 28
ACA Pays Off for Health Insurers Who Fought It as Stocks Hit High
January 28
Advocacy Group Calls for Dental Coverage, Prescription Price Controls
January 28
Panel: More Care Expected to Take Place in Homes, but Policy Changes Needed
January 28
Employers Not Fully Ready for ACA, Report Says
January 28
CRS Report, ‘The Affordable Care Act and Small Business: Economic Issues' (1/15/15)
January 28
CMS Frequently Asked Questions on Medicaid Managed Care Marketing Regulations (1/16/15)
January 28
OIG Report, ‘Federal Marketplace: Inadequacies in Contract Planning and Procurement' (1/20/15)
January 28
CONFERENCES
January 28