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Recent Increase in IRS Enforcement of ACA Reporting Penalties
"Although the IRS has regularly enforced failure-to-file penalties since the law's enactment, employers subject to the ACA and related information reporting requirements have just recently begun receiving notices of late filing penalties for the 2017 reports submitted. Employers should be aware that the IRS is signaling stepped-up enforcement of ACA compliance for 2017 and subsequent tax years."
Hanson Bridgett LLP
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ACA Round-Up: Health Insurance Tax, Mental Health Parity, and Special Enrollment Periods
"As we await the 2020 open enrollment period (which starts in November) and major rules like the notice of benefit and payment parameters for 2021 (which is expected this fall), federal agencies continue to release new guidance and analysis. Federal regulators have recently released an estimate of the health insurance tax plan for year 2020, frequently asked questions on mental health parity, and special enrollment periods for those affected by Hurricane Dorian."
Katie Keith, in Health Affairs
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2019 Medical Loss Ratio Rebates
"Using data reported by insurers to CMS, [KFF estimates] insurers will be issuing a total of at least $1.3 billion across all markets -- exceeding the previous record high of $1.1 billion in 2012 (based on 2011 experience). The amount varies by market, with insurers reporting at least $743 million in the individual market, $250 million in the small group market, and $284 million in the large group market."
Henry J. Kaiser Family Foundation
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Obamacare Caused Premiums to Spike; Here's How States Are Lowering Them Again
"Premiums for benchmark plans in 2019 are lower in six of the seven states that have ... waivers in place. The median premium decrease in those six states was 10.72%. Premiums rose by a median of 6.32% in 31 of the 44 states and the District of Columbia that did not obtain waivers. The median premium decrease in the 13 non-waiver states in which they declined was 5.67%, much lower than the median decrease in the six waiver states whose premiums fell in 2019."
The Heritage Foundation
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Navigating the Payer-Provider Relationship
"[1] Keep communications with payers clear, open, and transparent to maintain a long-lasting relationship. [2] Develop a structured process for monitoring payer changes to avoid reimbursement surprises post-claim. [3] When needed, officially object to payer changes that are relevant to your business, while still understanding that changes are often necessary. [4] Maintain good relationships to enable innovative partnerships."
HealthLeaders Media
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Investors' Deep-Pocket Push to Defend Surprise Medical Bills
"Often led by doctors with the veneer of noble concern for patients, physician-staffing firms -- third-party companies that employ doctors and assign them out to health care facilities -- have opposed efforts to limit the practice known as balance billing.... But as lobbyists purporting to represent doctors and hospitals fight the proposals, it has become increasingly clear that the force behind the multimillion-dollar crusade is not only medical professionals, but also investors in private equity and venture capital firms."
Kaiser Health News
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CVS Wants to Create a Netflix-Like Healthcare Experience
"CVS Health wants to connect the physical and digital experience to expand consumers' access to care ... Those experiences could be a virtual doctor visit, using an AI-powered chatbot or sending health data to a physician through a connected device ... The company is investing heavily in its technology infrastructure and wants to leverage the differentiated capabilities of both companies, and its combined size, to move forward with innovation[.]"
FierceHealthcare
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[Opinion]
Groupon for Healthcare Services May Fill a Void for Consumer-Focused Pricing
"The use of Groupon and other pricing tools is symptomatic of a healthcare market where patients desperately want a deal, according to a [recent article]. What’s driving consumers to use such pricing tools for healthcare services is the high cost of care (and high cost sharing for those who are insured) coupled with the lack of price transparency that enables patients to shop for scheduled elective services."
Healthcare Financial Management Association [HFMA]
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Benefits in General
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Financial Wellness Statistics: Reasons to Adopt a Program
"Here's exactly how these programs help ... [1] ~3% reduction in employee wage garnishing ...[2] 1% lower employee turnover ...[3] 24.6% reduction in absenteeism ...[4] Lower healthcare costs -- $271.50 saved per employee per year ...[5] 13% increase in employees on track to retire on time ...[6] 25.6% increase in HSA and FSA contributions."
ForUsAll
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Most Popular Items in the Previous Issue
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