Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

Blue Shield of California's proposed Care1st acquisition to go before public

The California Department of Managed Health Care will soon hear from both San Francisco-based Blue Shield of California and Medicaid insurer Care1st regarding  Blue Shield's proposed acquisition of Care1st, the department announced this week.

King v. Burwell: What the Supreme Court decision will mean for providers

Joseph Swedish, president and CEO of Anthem Inc. and Michael Leavitt, former secretary of the Department of Health and Human Services, discussed the implications of the Supreme Court's upcoming ruling in King. v. Burwell for providers at the American Hosptial Association's annual meeting. 

Risk corridor program may hurt insurers, cause market uncertainty

It's possible that the Affordable Care Act's risk corridor program may end up hurting health insurers, according to a recent Standard & Poor analysis.

Karen DeSalvo to step down as ONC head if confirmed for HHS role

President Barack Obama late Wednesday announced his intent to nominate current National Coordinator for Health IT Karen DeSalvo for Assistant Secretary for Health at the Department of Health and Human Services.

Former hospital CFO to repay $4.4M over EHR fraud

Former hospital chief financial officer Joe White has been ordered to pay $4.4 million in restitution after pleading guilty in November to making a false statement to the government about Meaningful Use attestation.

Care quality no worse for ACA exchange patients

The Affordable Care Act has narrowed patient networks in California, but at no overall cost to care quality, according to a new study published in Health Affairs.

States played key role in enforcing network standards in 2014

While the Affordable Care Act established network requirements for plans in the commercial marketplaces, states played a role in both setting and enforcing such standards in 2014,  according to the Commonwealth Fund.  

Dear Congress: Don't greenlight an ICD-10 ban

In Hollywood, studio executives have a tendency to milk every drop out of a movie franchise until its appeal dries up and withers away. Nowhere is this more evident than in the horror genre, where shark attacks have been reduced to a punchline, and masked serial killers continue to breathe oxygen after a countless number of deaths.

Concentrated concierge practices: Too much of a good thing?

Concierge medicine, while growing modestly overall, is becoming more predominant in certain pockets of the country. But despite reports that the model produces high satisfaction for all involved, a high concentration of retainer-based practices represents challenges for patients and physicians.

More than 40% of insurers aren't paying ACA taxes; IRS to beef up enforcement

The IRS isn't doing a good enough job to ensure insurers pay a fee required under the Affordable Care Act, according to a recent report from the Treasury Department.