Policy and Regulation

Opposition Increases to Aetna, Anthem Health Insurance Mergers

by Vera Gruessner

The health insurance mergers between Aetna and Humana along with Anthem and Cigna seem to have a fair amount of opposition from both healthcare organizations as well as politicians around the country....

Republicans Release Plan to Replace the Affordable Care Act

by Vera Gruessner

It is well-known the the GOP base has attempted to repeal the Patient Protection and Affordable Care Act for years since its passage. However, the big question that everyone has always wondered is what...

How the Affordable Care Act Changed the Face of Health Insurance

by Vera Gruessner

The Patient Protection and Affordable Care Act (ACA) has revolutionized the health insurance industry in a number of ways. Its impacts have been vast and wide. One of the most significant impacts of the landmark legislation is the upward...

What Repealing the Affordable Care Act Would Mean for America

by Vera Gruessner

While the Patient Protection and Affordable Care Act was passed into law six years ago, there is still plenty of controversy that surrounds this landmark legislation. For instance, the Senate and House...

Affordable Care Act Brought Healthcare Coverage to Rural Areas

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a fair amount of healthcare access and coverage to the American people. This does not just include those living in urban areas or the suburbs....

Indiana, Florida Approve Anthem, Aetna Health Insurance Mergers

by Vera Gruessner

The major health insurance mergers taking place between Anthem-Cigna and Aetna-Humana have shown some progress of late. Recently, the Indiana Department of Insurance approved the acquisition between...

Health Insurance Market Faces Restricted Provider Networks

by Vera Gruessner

Last week, Scott Gottlieb, MD, Resident Fellow at the American Enterprise Institute, spoke in front of the House Committee on Energy and Commerce Subcommittee on Health delivering key information about...

Supreme Court Leaves Zubik v. Burwell Case to Lower Courts

by Vera Gruessner

On Monday, the Supreme Court unanimously called for the lower courts to rule on the Zubik v. Burwell case and to find a compromise. This particular court case argues on whether employers, specifically...

Court Sides with Republicans on Affordable Care Act Provision

by Vera Gruessner

Once again, the Patient Protection and Affordable Care Act is receiving criticism from the Republican-led House of Representatives. House Republicans had filed a lawsuit claiming that the Obama...

Audits against Medicare Advantage Organizations Found Subpar

by Vera Gruessner

In order to ensure government funding isn’t used to pay erroneous or fraudulent medical claims, the Centers for Medicare & Medicaid Services (CMS) conducts risk adjustment data validation...

Health Insurance Exchange Consumers Satisfied with Health Plans

by Vera Gruessner

Despite the fact that the House of Representatives and the Senate attempted to repeal the Affordable Care Act at the end of 2015, consumers seem to be satisfied with their healthcare coverage options...

The Biggest ACA Legal Challenges Facing Healthcare Industry

by Vera Gruessner

Ever since the Obama administration passed the healthcare law to reform many of the inequalities faced in this country, there have been a wide variety of ACA legal challenges that have stood in the way...

Is the Medicare Part B Proposed Rule ‘Bad Medicine’?

by Vera Gruessner

Two months ago, the Centers for Medicare & Medicaid Services (CMS) announced a new proposed rule that would create new payment models meant to reimburse providers for assigning prescription drugs....

What will the Future Bring for the Affordable Care Act?

by Vera Gruessner

The future of the Affordable Care Act and health insurance exchanges may not be as favorable as the Obama administration had hoped. Many fear that the major health insurer UnitedHealthcare leaving the...

Did the Affordable Care Act Lower Medicare Spending?

by Vera Gruessner

The Affordable Care Act and other regulatory changes were meant to reform the healthcare industry and save costs on wasteful spending. Recent results coming from the Department of Health and Human...

Long-Term Care has a Shorter Time Frame Due to ACA, CMS

by Vera Gruessner

The Affordable Care Act has impacted a variety of aspects of the health insurance landscape as well as the healthcare delivery system. The Patient Protection and Affordable Care Act also led to the...

New Proposed MACRA Rule Renovates Information Technology Use

by Vera Gruessner

The Department of Health & Human Services (HHS) has proposed new rules regarding the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) which will essentially remove the meaningful use...

Consumer Engagement Vital in Health Insurance Exchanges

by Vera Gruessner

The Patient Protection and Affordable Care Act has brought a variety of changes for both insurers and healthcare providers with the establishment of health insurance exchanges holding a top place in...

Proposed Rule in Oklahoma Impacts Costs of Prescription Drugs

by Vera Gruessner

In recent months, scandals associated with the costs of prescription drugs have made headlines. About seven out of 10 Americans are currently enrolled in a health insurance plan that covers costs of...

CMS Releases Medicare Data for Quality-Based Metrics

by Vera Gruessner

The Centers for Medicare & Medicaid Services (CMS) is further attempting to innovate and improve medicine through quality-based metrics, as the CMS Office of Minority Health has released new data...