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The long-awaited rules from the Office of Civil Rights in the Department of Health and Human Services further define protections included in the Affordable Care Act, particularly broadening those for transgender Americans. MORE
Even when a natural disaster doesn't force a hospital to shut its doors, unexpected catastrophes can disrupt operations and finances. MORE
The Marketplace Navigator grants only apply to groups in the 34 states that run federal exchanges. MORE
While hospital merger and acquisition deals in the second quarter of 2015 slid when it came to volume, the total dollar amount of the deals jumped on a few major takeovers, according to new research by PricewaterhouseCoopers. MORE
Colorado's uninsured rate has plummeted from a recent high of 15.8 percent four years ago to 6.7 percent this year, but the success of the Affordable Care Act in Colorado is almost entirely the result of Medicaid expansion, according to a much anticipated survey from the Colorado Health Institute. MORE
While many accountable care organizations in Medicare's Shared Savings Program generated enough savings in 2014 to merit financial incentives, more than two-thirds fell below the payment threshold, the Centers for Medicare & Medicaid Services said on Tuesday. MORE
Nine ACOs that partner with CHS generated $27 million in the Medicare Shared Savings Program. MORE
Two Pioneer Accountable Care Organizations, Montefiore Health and the Banner Health Network, on Tuesday touted their success in generating savings for the Centers for Medicare & Medicaid Services ACO model. Though other organizations in the group found little reason to celebrate. MORE
Amputees against proposed changes to Medicare coverage that would result in less expensive, but inferior, prosthetics being given to patients gathered in Baltimore Wednesday to ask officials to strike down the proposal. MORE
A new report published in the American Journal of Managed Care found that just over half of MSSP ACOs shared plans on how they'll allocate savings. MORE
More than 2 million people with coverage on the health insurance exchanges may be missing out on subsidies that could lower their deductibles, copayments and maximum out-of-pocket spending limits, according to a new analysis by Avalere Health. MORE
MeriTalk report claims 11 percent of people who receive government healthcare benefits are not actually eligible. MORE
Narrow insurance networks are gaining traction across the United States, as insurers have limited options for offering plans at different price points, according to a report by the Leonard Davis Institute of Health Economics and the Robert Wood Johnson Foundation. MORE
Experts say problems seen in September in testing ICD-10 codes could turn into disasters when the new diagnostic code set goes live on October 1. MORE
Though critical access hospitals will continue to earn less, Fitch Ratings this week said it does not expect the financial struggles to affect these hospitals' credit ratings due to their near 100 percent reimbursement from Medicare and political support that will stave off any attempt to cut payments. MORE
Pennsylvania families that faced penalties for Children's Health Insurance Program coverage that did not meet minimum requirements set by the Affordable Care Act are in the clear after Gov. Tom Wolf on Thursday said the state expanded its CHIP program. MORE
Republican presidential candidate Scott Walker has released details of a healthcare model to replace Obamacare that would give tax credits to seniors to buy their own insurance. MORE
Blue Cross and Blue Shield of Illinois has developed accountable care organizations with three more provider-partners, bringing the total number of ACOs under the insurer to five, the insurer announced this month. MORE
A doctor at a Brooklyn, New York, clinic was sentenced Friday to two years in prison for his role in a $13 million healthcare fraud scheme, according to the U.S. Department of Justice. MORE
Remember the so-called death panels? When Congress debated the Affordable Care Act in 2009, the legislation originally included a provision that would have allowed Medicare to reimburse doctors when they meet with patients to talk about end-of-life care. MORE
A new report shows $342 billion in taxpayer money is wasted each year in improper healthcare payments due to challenges in verifying benefit eligibility. MORE
Most insurance plans established under the Affordable Care Act are losing money and may have difficulty repaying millions in loans, according to an audit report released by the Office of Inspector General. MORE
Florida will audit 31 hospitals which failed to meet a deadline to certifying that their contracts with Medicaid managed-care plans comply with state law, according to Gov. Rick Scott's office. MORE
More than 2,100 healthcare providers have passed through the review stage and will begin taking on financial risk in the Centers for Medicare and Medicaid Services Bundled Payments for Care Improvement Initiative, the federal agency announced on Thursday. MORE
One of the health law's key protections was to cap how much consumers can be required to pay out of pocket for medical care each year. Now some employers say the administration is unfairly changing the rules that determine how those limits are applied, and they're worried it will cost them more. MORE
The merger between Aetna and Humana didn't come together overnight. In fact, based on a new Securities and Exchange Commission filing by Humana outlining the takeover, the deal stretches back to October 2014. MORE
The Centers for Medicare and Medicaid Services said it will delay releasing data on its risk corridor ratios for insurers participating in health insurance exchanges after it found several discrepancies in the data. MORE
Internal controls are lacking when it come to setting an individual's eligibility for tax credits and cost sharing reductions for health plans bought through, according to a new report by the Office of the Inspector General. MORE
Two major deals that would result in top commercial insurance companies merging into their competitors has roiled the leadership of the American Hospital Association. MORE
The last and perhaps most controversial piece of health reform's universal coverage has many miles to go in terms of financial sustainability. But there are signs of progress. MORE
"Are you pregnant?" It's a topic employers have avoided since the Pregnancy Discrimination Act of 1978. But advocates fear these long-standing protections could be undermined by some workplace wellness programs. MORE
Another insurer is embracing the idea of paying for direct primary care, sponsoring new clinics and a new kind of medical practice. MORE
People enrolling in public health insurance exchanges are more willing to switch plans, placing pressure on insurers to continually win over shoppers based on price, product and service, according to a new report by Deloitte. MORE
The Centers for Medicare and Medicaid Services and the State of Rhode Island are contracting with a Medicare-Medicaid plan to provide integrated benefits to approximately 30,000 eligible enrollees. MORE
When Michael Kamins opened the letter from his health plan he was enraged by what he encountered, a part of critics see as medical necessity's "last hurrah." MORE
Billions of dollars have been spent on 90 deals over the past decade. See which five companies are responsible. MORE
Pat Hemingway Hall, one of the most successful female executives in the health insurance industry, is leaving behind a giant nonprofit company that is still evolving. MORE
Assurant is advancing plans to wind down its once-profitable health insurance business, though apparently has not found a buyer for it. MORE
Like most mergers and acquisitions, the Aetna-Humana and Anthem-Cigna deals will need a fair amount of cultural alignment to yield the market complementaries and business synergies being promised amid the record-breaking valuations. MORE
Another ACA-funded co-op is going under, dissolving rather than confront an "unhealthy future." Many of the others are also struggling to stay in the black. MORE
Premiums for 1.3 million Covered California consumers will rise an average 4 percent, slightly less than last year's increase of 4.2 percent. MORE
A "sleeper" provision when Congress created Medicare in 1965 to cover healthcare for seniors, Medicaid now provides coverage to nearly one in four Americans, at an annual cost of more than $500 billion. Today, it is the workhorse of the U.S. health system, covering nearly half of all births, one-third of children and two-thirds of people in nursing homes. MORE
A $57 million experiment to deliver better, more efficient care at federally funded health centers struggled to meet its goals and is unlikely to save money. MORE
Anthem will buy Cigna for $54.2 billion, the insurer announced on Friday, in a deal that will reduce the former "Big Five" private health insurers to just three. MORE
Some analysts who have looked at health insurers' proposed premiums for next year predict major increases for policies sold on state and federal health exchanges. Others say it's too soon to tell. One thing is clear: There's a battle brewing behind the scenes to keep plans affordable for consumers. MORE
The public health pitch for making Medicare available at 50 comes with some strong evidence and business opportunity for population health. MORE
Amid a planned acquisition by Aetna, Humana is still going forward with new models, including an expanded deal with one of several promising primary care ventures. MORE
Primary care incentives for ACOs may not be strong enough to accomplish the goals of improving patient experiences, population health and high costs. MORE
With a progressive CEO and culture and a huge merger in the works, Aetna is promising to help reinvent healthcare. Yet it is still up against the long-term unknowns about what will constitute truly sustainable healthcare. MORE

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