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Health Plan Transparency – What is Pinnacle doing for you?

Pinnacle Claims Management Health Plan Transparency Pinnacle is committed to our clients, and as such, we actively work to ensure you receive the necessary guidance as it pertains to legislative changes in health care. There have been several provisions of the Consolidated Appropriations Act of 2021 (CAA)

Mar 07, 2022 | Blog

FAQs – Transparency in Coverage and Consolidated Appropriations Act [Updated 3/4/22]

Transparency in Coverage and Consolidated Appropriations Act FAQs for Employers [UPDATED 3/4/22] TRANSPARENCY IN COVERAGE – FINAL REGULATION Pinnacle Claims Management, Inc. supports transparency efforts to help our members make informed health care decisions. In October 2020, the Departments of Health and Human Services, Labor, and Treasury

Mar 03, 2022 | Blog

New COVID-19 Supplemental Paid Sick Leave Bill (AB 84) Signed by Gov. Newsom

California’s latest COVID-19 Supplemental Paid Sick Leave Bill (AB 84) was signed into law on February 9, 2022 by Governor Newsom. Details of this new legislation are set out below. Employee Use of COVID-related Supplemental Paid Sick Leave (SPSL) SPSL is available for employees unable to work

Feb 11, 2022 | News

COVID-19 UPDATE: Coverage for At-Home COVID-19 Tests

On January 10, 2022, the Biden Administration announced that, beginning January 15, individuals with private health insurance coverage or covered by a group health plan who purchase an over-the-counter COVID test authorized, cleared, or approved by the U.S. Food and Drug Administration (FDA) will be able to

Jan 17, 2022 | Blog

UPDATE – Consolidated Appropriations Act

On December 27, 2020, President Trump signed Consolidated Appropriations Act, 2021 (“Act”). The voluminous appropriations and COVID-19 relief package also includes the most significant health care legislation since the Affordable Care Act, addressing balancing billing and cost transparency, as well as extending the COVID-related FSA relief measures

Nov 29, 2021 | News

Deferral of Enforcement of Transparency Rules

Introduction In October 2020, the Departments of Health and Human Services, Labor, and Treasury (collectively referred to as the “Departments”) released the Transparency in Coverage Final Rules (TIC) requiring, among other things, that non-grandfathered health plans disclose, on a public website, three machine-readable files disclosing health care

Aug 30, 2021 | News

Anthem Blue Cross and Dignity Health (“Dignity”) Contract Update

To our valued clients: We are pleased to announce that Anthem Blue Cross (“Anthem”) and Dignity Health (“Dignity”) have reached a new contract agreement that returns Dignity facilities to the Anthem network. The agreement is retroactive to July 15, 2021, and any care provided and received through

Aug 17, 2021 | News

Consolidated Appropriations Act 2021

Dear Valued Clients, On December 27, 2020, President Trump signed Consolidated Appropriations Act, 2021 (“Act”). The voluminous appropriations and COVID-19 relief package also includes the most significant health care legislation since the Affordable Care Act, addressing balancing billing and cost transparency, as well as extending the COVID-related

Aug 16, 2021 | Blog

Hospital Contract Termination: Anthem Blue Cross and Dignity Health (“Dignity”)

Anthem Blue Cross and Dignity Health (“Dignity”) have been engaged in negotiations for several months to reach a new contract agreement in California and Nevada for hospital and physician services. Unfortunately, to date, Anthem Blue Cross and Dignity have been unable to come to terms on a new contract that provides greater affordability for our members, and their commercial hospital contract with Dignity may terminate effective July 15, 2021. Anthem Blue Cross continues to negotiate in good faith with Dignity Health in an effort to reach an agreement before the termination date.

Jul 16, 2021 | News
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