Insurers anticipate early ICD-10 billing problems

As today begins the transition to the new ICD-10 medical codes, health insurance companies are anticipating potential billing problems as a result of the transition. 

Majority of Americans oppose Cadillac tax

As leaders on both sides of the political spectrum have begun to oppose the Affordable Care Act's Cadillac tax that will go into effect in 2018, the American public appears to dislike the provision as well.

In latest hearing, provider groups come out swinging against insurer mergers

During the third of three recent hearings on consolidation in the healthcare industry, representatives from the provider community made it clear that they are not going to let the pending health insurer mergers go down without a fight.


Privacy concerns arise when wellness programs share data with vendors

There are major privacy concerns about workplace wellness programs that share employees' information with outside vendors, according to a report by Kaiser Health News.

Clinton joins call to repeal ACA's Cadillac tax

Democratic presidential candidate Hillary Clinton announced Tuesday that she is in favor of repealing the hotly debated Cadillac tax, which places a 40 percent tariff on individual health insurance plans that cost more than $10,200 a year and family plans that cost more than $27,500 starting in 2018. 


For insurers, tax time creates opportunity to reach uninsured Americans

Insurers should take advantage of the connection between health coverage enrollment and the tax filing season to get uninsured Americans to sign up under the Affordable Care Act. 

CMS to test enhanced medication therapy model for Medicare Part D

The federal government will test a model that it hopes will improve medication compliance and reduce medication problems among Medicare Part D beneficiaries. 

Role of ACA enrollment navigators, assisters continues to evolve

As the Affordable Care Act enters its third open enrollment period, the role of navigators and assisters remains crucial to the health law's success, but it is likely to continue to evolve, according to new Health Affairs policy brief.

Survey: Increasing interest in private exchanges will have major impact on health plans

As private insurance exchanges are becoming a more popular option for companies, an understanding of employers' preferences is vital for health plans to succeed in the private exchange business. 

Medicaid directors' inadequate pay may hurt program's success

Medicaid is typically a state's largest centrally managed program, and has significant impact on other healthcare sectors nationwide. But despite the program's complexities, it does not always have the tools to maintain operational success.


Insurers face $4.9M penalty for late filing of IRS form

Health insurers that were late filing a form with the government avoided paying an annual fee tied to the Affordable Care Act, but they may face total penalties of more than $4.9 million, according to a new report from the Treasury Inspector General for Tax Administration.

GAO criticizes oversight of Medicare Advantage network adequacy

The rules governing Medicare Advantage Organization networks lack certain elements to ensure that beneficiaries are able to acccess care in a timely manner, according to a new report.


State insurance regulators take on narrow-network debate

In an effort to better regulate narrow networks, the National Association of Insurance Commissioners is working to hash out a new model network adequacy law, reports Managed Care magazine.

Karen Ignagni's big challenge is to turn around EmblemHealth's financial health

After almost a month in her new job as head of New York nonprofit insurer EmblemHealth, Karen Ignagni says she has shifted gears and is embracing the new challenges that come with actually running a health insurance plan.

Trump unveils plan to repeal, replace ACA

Republican presidential candidate Donald Trump offered details about his plan to repeal and replace the Affordable Care Act in a recent interview with "60 Minutes." 

Boehner leaves behind fraught legacy in fight against ACA

When John Boehner retires as Speaker of the House, it will mark the end of the Ohio Republican's complicated and conflict-fraught relationship with the Affordable Care Act.

More CO-OP woes: Health Republic Insurance of New York to stop selling coverage

Health Republic Insurance of New York will discontinue selling policies at the end of this year, becoming just the latest state-based consumer operated and oriented health planto fail after struggling with financial difficulties. 


Too soon for Aetna, Anthem to declare victory in merger review process

When it comes to the rigorous review process that major industry mergers must face, how soon is too soon to declare victory? Personally, I would argue that any time before the Department of Justice...

6 startups using tech and data to challenge the health insurance industry status quo

The health insurance industry is among the toughest businesses to break into--the sector is dominated by several large players that dwarf their competition's market share. But the individual market created by the Affordable Care Act and the rise of consumerism have spawned a slew of startup companies trying to elbow their way into the health insurance space. In this slideshow, FierceHealthPayer highlights six new health insurance startups. 

Sanders, Senate Democrats introduce bill to repeal Cadillac tax

Presidential candidate Bernie Sanders and a group of Senate Democrats introduced a bill Thursday to repeal the Cadillac tax, which would place a 40 percent levy on certain high-cost employer health plans starting in 2017.