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Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

HHS could pay out $1B to insurers for reinsurance, risk corridor, risk adjustment

The Department of Health and Human Services will likely be paying insurers more than $1 billion this year for the "three Rs" of the Affordable Care Act--risk adjustment, reinsurance and risk corridors--according to a new Citigroup report.

Karen DeSalvo steps down from ONC post; Jacob Reider to leave in November

Karen DeSalvo will step down from her role as National Coordinator for Health IT, effective immediately, to serve as Acting Assistant Secretary for Health at the U.S. Department of Health and Human Services. Deputy National Coordinator Jacob Reider also will step down in late November.

HLC's Mary Grealy: Interoperability mandate in next SGR bill wouldn't surprise me

In discussing the bevy of hurdles impeding the path to interoperability in healthcare at the Workgroup for Electronic Data Interchange's annual fall conference this week, Mary Grealy, president of the Healthcare Leadership Council, which represents chief executives from healthcare companies and organizations nationwide, outlined several steps and principles necessary to guide that transition.

HHS initiative will fund care improvement efforts

The U.S. Department of Health & Human Services today announced it would spend up to $840 million over the next four years to fund innovative healthcare strategies designed to improve patient care and lower costs. 

Some hospitals may withhold care from Ebola patients

Some U.S. hospitals may withhold medical interventions from Ebola patients for the sake of their workers' safety, Reuters reports.

Insurers can cancel exchange plans if subsidies ruled illegal

Insurers that sell plans on the federal health insurance exchange can cancel the policies if the Affordable Care Act subsidies are ruled illegal.  The Centers for Medicare & Medicaid Services added the opt-out clause to 2015 contracts that insurers must sign to sell on HealthCare.gov

Karen DeSalvo: Interoperability won't come easy

At the Workgroup for Electronic Data Interchange's annual fall conference in Reston, Virginia on Tuesday, National Coordinator for Health IT Karen DeSalvo reiterated the challenges and goals associated with implementing ubiquitous interoperability throughout the healthcare industry.

MGMA awards offer lessons on winning big, even outside of Vegas

This week, the Medical Group Management Association (MGMA) recognized several of its members for excellence in medical practice management with a series of awards. The recipients' achievements...

Do state officials have authority over Medicare Advantage insurers?

As Pennsylvania officials have attempted to force Highmark into expanding its Medicare Advantage network, Highmark pushed back by claiming that the state lacks authority over the federal program.

RWJF: Essential benefit requirements vary widely among states

States require insurers to include a wide array of essential health benefits in their plans, making it challenging for insurers to sell plans across state lines, according to a new report from the Robert Wood Johnson Foundation.