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Policy and Legislation

 
December 17, 2014 | Anthony Brino

A fractious and potentially costly family of provider-led class action lawsuits are moving through courts, pitting accusations of illegal clawbacks againsts the likes of Aetna and UnitedHealth Group.


November 24, 2014 | Anthony Brino

A tension between transparency and trade secrets has surfaced in North Carolina, where the state's largest insurer believes a new disclosure law will have unintended consequences.


November 24, 2014 | Jay Hancock

The Obama administration took another step to close what many see as a health-law loophole that allows large employers to offer medical plans without hospital coverage and bars their workers from subsidies to buy their own insurance.


November 10, 2014 | Anthony Brino

What was once thought to be a Hail Mary attempt by Affordable Care Act opponents is now starting to look like a clear pass with a chance of being caught.


November 5, 2014 | Anthony Brino

Health insurers in the nation's largest market are breathing a collective sigh of relief after escaping a new rate review system, but they may have to fight the battle again.


November 5, 2014 | Anthony Brino

How will a long-time insurance manager fix the crisis in a state with some of the most expensive and advanced healthcare on the planet?


November 3, 2014 | Anthony Brino

Already big and still growing, the U.S. healthcare system in 2015 will be scrutinized inside and out for signs of financial problems, the federal government's health investigator promises.


October 30, 2014 | Anthony Brino

Many health insurers have spent close to a century operating under fee-for-service and are now changing course. Some new payers founded post-health reform, however, are trying to hit the value-based ground running.


October 17, 2014 | Jay Hancock

Insurance consultants were shocked recently to learn that Obama administration rules allow large companies to offer 2015 worker health plans that don't include hospital benefits. Now the administration is concerned too.


August 22, 2014 | Michelle Andrews

How much leeway do employers and insurers have in deciding whether they'll cover contraceptives without charge and in determining which methods make the cut? Not much, as it turns out, but that hasn't stopped some from trying.


August 7, 2014 | Anthony Brino

Federal health officials are increasingly scrutinizing Medicare Advantage risk adjustment, suggesting policy changes and even clawbacks to come.


July 28, 2014 | Anthony Brino

Incorporating federal sequestration into Medicare Advantage provider reimbursement has spurred a new lawsuit, and one that could spell trouble for other plans.


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