Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

Good luck getting specialty provider prices in Massachusetts

Despite enacting a groundbreaking law on healthcare price transparency, it remains difficult to actually obtain prices from Massachusetts providers, according to a second study this year by the Pioneer Institute, which surveyed the offices of more than 90 specialty providers such as gastroenterologists, dermatologists, ophthalmologists and dentists.

Customers sue CareFirst following cyberattack

CareFirst BlueCross BlueShield has become the latest insurer to be slapped with lawsuit following a cyberattack that compromised its customers' sensitive information.  

Vermont to dish out $1.6 million to Blue Cross Blue Shield of Vermont

Vermont plans to pay $1.6 million to Blue Cross Blue Shield of Vermont to cover past-due premiums and incorrectly paid claims that resulted from the state's  disastrously run health insurance exchange.

Insurers fall short when it comes to covering substance abuse treatment

Many health insurance companies are feeling the heat from consumers after they learn that their plans won't cover services for substance abuse counseling.

Sensational reports of health insurance premium hikes misleading, incomplete

Guest post from Joel White, president of the Council for Affordable Health Coverage At the end of July, CEO Kevin Counihan sent a letter to insurance commissioners, urging them to...

Fewer than expected buy coverage during tax season enrollment period

About 950,000 new customers selected a health insurance plan on during the special enrollment period from Feb. 23 to June 30, and 15 percent of those people signed up during tax season to avoid paying a fee for lack of coverage.

D.C. officials stopped insurer from adverse tiering of HIV drugs

An insurer operating in the District of Columbia was discriminating against its members with HIV by requiring them to pay disproportionately expensive copays to treat their condition. 

More hospital systems jump on urgent care bandwagon

More hospitals and health systems plan to join the retail healthcare movement and open urgent care centers in response to consumer demand for faster and convenient access to care.

CMS extends two-midnight rule enforcement delay

The Centers for Medicare & Medicaid Services  will extend its partial enforcement delay of the unpopular two-midnight policy until the end of the year. The postponement coincides with proposed changes to the short-stay rule that the agency issued in July.

Aetna-Humana deal followed months of negotiations among major insurers

It's no secret that the health insurance industry has been subject to a flurry of deal-making in recent months, but a new Securities and Exchange Commission filing by merging insurers Aetna and Humana offers a unique peek into the behind-the-scenes negotiating that ultimately would reshape the industry.