The Affordable Care Act (ACA) imposes a fee on health insurance issuers and plan sponsors of self-insured health plans to help fund the Patient-Centered Outcomes Research Institute (PCORI). The PCORI fee was scheduled to expire for plan or policy years ending on or after October 1, 2019. However, a federal …
As the current pandemic continues to raise health concerns, many health insurance carriers have taken the initiative to ensure members have continued coverage for and access to COVID-19 related testing and treatment. For instance, Cigna announced they have extended their previously announced support for customers, by implementing the following COVID-19 …
The proactive response made to help flatten the COVID-19 curve and preserve personal protective equipment (PPE) has impacted the healthcare economy in profound ways, especially to the dental industry. On March 16, 2020, the American Dental Association (ADA) issued guidance stating that dental practices need to postpone elective procedures and …
Across the nation, we continue to witness the high demand and stress the COVID-19 pandemic is placing on our healthcare system. While challenges and uncertainty continue to present themselves, costs increase. The healthcare marketplace’s combined costs for testing, treating, and caring for patients is estimated to rise from $56 billion …
President Trump signed the newest coronavirus aid bill into law, which provides $484 billion in relief funding. This funding will be allocated to small businesses and hospitals under stress due to the pandemic, as well as to expanding COVID-19 testing. Breakdown of the Bill Earlier this month, when funding for …
Across the nation, our healthcare system has had to face a plethora of challenges. The COVID-19 crisis continues to place high demand and stress on healthcare workers, specifically, those on the front lines of patient care and treatment. Virtual care has surfaced as one of the best solutions to address …
It’s essential for patients that are experiencing serious illness, including symptoms of COVID-19, to have access to necessary treatment and prescription medication. In efforts to protect those with chronic conditions from medication shortages, CVS Caremark recently set new guidelines to limit the purchase of essential medications. Medications to help ease …
CVS Health has designed a new program called RxZERO, which aims to provide affordable medications to individuals living with diabetes without the astronomical out-of-pocket expenses. “Eliminating out-of-pocket costs for diabetes medications ensures long-term affordability, improves adherence and, most importantly, puts patients on the path to better health.” Dr. Troyen A. …
On February 4, 2020, President Donald Trump delivered the 2020 State of the Union Address (SOTU) to a joint session of Congress. A series of topics were presented including private healthcare, federal paid family leave and prescription drug cost reform. These items have already made significant impacts on the employee’ …
CVS Health plans to launch a new insurance product by the end of March 2020. It will absorb the astronomical expenses health plan members experience when undergoing gene therapy. “With prices for a single treatment as high as $2 million, many employers are struggling to find ways to offer coverage …
On December 18, 2019, it was released that New York Life Insurance Co. agreed to pay $6.3 billion for a Cigna Corp. unit that sells non-medical insurance products to employers. New York Life Insurance Co. is one of the nation’s oldest and financially strongest life insurers. As low interest rates …
On June 24, 2019, President Trump signed an executive order aimed at improving price and quality transparency in healthcare. Click here for more information. On November 15, 2019, the Department of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) issued a proposed rule regarding transparency in coverage …
On Friday, November 15, 2019, the Trump administration released its final rule regarding hospital price transparency, which will take effect in 2021. What does this new rule mean? Hospitals will now be required to provide easily accessible billing information to patients. This means having all standard charges available online and …
On November 8, 2019, the Department of Labor (DOL) and Health and Human Services (HHS) issued an updated template and related materials for the Summary of Benefits and Coverage (SBC). The following updated materials must be used for plan years beginning on or after January 1, 2021: SBC Template, Uniform …
An EOB is a form that insurance companies send to their members to explain what part of a claim was paid by insurance, what part was not paid and why. Frequently, the terminology and language used on an EOB requires advanced understanding of medical procedure naming conventions and insurance contract …
