Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

As the health insurance merger world turns: Drama, plot twists and cliffhangers

While predictions that the Affordable Care Act would force insurers that specialize in employer-sponsored health plans to recalibrate haven't really panned out, many analysts agree that the decision to uphold a key facet of the ACA provided the stability necessary for deal-hungry insurance companies to make a move. And move they have. Here are some of the recent developments in the soap opera I've come to call "How the Insurance World Turns."

Regulatory watchdog calls for more transparency on CMS star-rating methodology

The Centers for Medicare & Medicaid Services failed to comply with notice-and-comment laws and wasn't transparent in its methodology when it made changes to its five-star ratings system, according to a letter from the Center for Regulatory Effectiveness, an independent watchdog group.

Health industry resists safety protocols to protect worker injuries

A new report from the advocacy group Public Citizen says that hospital executives and administrators have no plan of action for lowering the staggering rate of on-the-job injuries for nurses. Furthermore, institutions appear to resist any government attempt to regulate the industry from the outside.

NIH seeks comment on mHealth tech use in Precision Medicine Initiative

The National Institutes of Health is considering incorporating smartphones and wireless technologies to collect data for the Precision Medicine Initiative and is seeking public feedback on the idea.

Massachusetts nurses complain of illegal mandatory overtime

Nurses at Addison Gilbert Hospital in Gloucester, Massachusetts and Beverly (Massachusetts) Hospital filed more than 50 complaints about mandatory overtime with the Massachusetts Nurses Association between January and late May, according to the  Gloucester Times. But representatives from Lahey Health, which run both hospitals, told the publication that the system did not violate state law.

CMS proposed payment schedule includes end-of-life planning

Physicians may soon be paid for  end-of-life conversations with their patients  under  proposed changes  to the 2016 Medicare Physician Fee Schedule--a move that could catch on with private payers, as well.

Lawsuit: Health Net discriminates against naturopathic doctors

Oregon-based Health Net is violating the Affordable Care Act by discriminating against naturopathic doctors and arbitrarily refusing to pay for covered services provided by these alternative providers, according to a lawsuit filed against the insurer.

Resident work-hour restrictions don't help patient outcomes

Although restrictions on the number of hours resident physicians work are meant to reduce medical errors, the work-hour limits do not improve patient safety, according to a study published in the  Journal of the American College of Surgeons.

Grace period agreement likely the death knell for another ICD-10 delay

In announcing a  joint effort with the American Medical Association to ease the transition to ICD-10 for providers, the Centers for Medicare & Medicaid Services on Monday essentially sounded the death knell for the possibility of a fourth delay.

Connecticut law contains new requirements for health insurers

A new Connecticut law imposes more stringent restrictions on health insurance companies, including new billing regulations and additional hurdles for insurers that purchase physician groups.