Policy & Regulations

This channel includes news coverage of healthcare policy and regulations set by Congress, the states, Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), U.S. Food and Drug Administration (FDA), and medical associations and societies. 

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Trump’s hospital transparency rule faces new challenge

A recent proposal from the Trump administration to force hospitals to publish their negotiated rates with insurers is facing a new legal challenge, according to Bloomberg Law.

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US social spending on pace with other countries

U.S. healthcare spending far outpaces other high-income countries, but social spending is not far off, just slightly below average, according to a new study published in Health Affairs.

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CMS to add star ratings to health plans

CMS is planning to add a star ratings system to insurance plans offered through the individual exchange created from the Affordable Care Act, the agency announced August 15. The new ratings will be displayed for the 2020 open enrollment period on Healthcare.gov.

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Changing up CMS model codes improves payment outcomes

A recent study published in JAMA Open Network found that using individual codes and present on admission designations instead of group codes can improve the predictability of patient total payment within 30 days of a hospitalization.

 

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Healthcare among top 10 fastest-growing companies

Two healthcare companies have made Inc.’s top 10 fastest-growing privately held companies in the U.S.

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Employers clamp down on rising healthcare benefit costs

Healthcare benefit costs in the U.S. are expected to rise 5% next year, causing large employers to up their efforts to save, according to a survey from the National Business Group on Health.

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Tufts, Harvard health plans to merge

Two institutional-based health plans in New England have announced their plans to merge.

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PBMs passed on 99% of rebates

Pharmacy benefit managers (PBMs) are only keeping less than 1% of rebates in the Medicare Part D program, passing on the rest of drug savings to plan sponsors, a report from the Government Accountability Office (GAO) found.

Around the web

With generative AI coming into its own, AI regulators must avoid relying too much on principles of risk management—and not enough on those of uncertainty management.

Cardiovascular devices are more likely to be in a Class I recall than any other device type. The FDA's approval process appears to be at least partially responsible, though the agency is working to make some serious changes. We spoke to a researcher who has been tracking these data for years to learn more. 

Updated compensation data includes good news for multiple subspecialties. The new report also examines private equity's impact on employment models and how much male cardiologists earn compared to females.

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