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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Healthcare groups outline 7 policy recommendations for surprise medical bill legislation

Prominent healthcare organizations, including the American College of Radiology (ACR) and American Medical Association (AMA), have asked Congress to consider certain policy recommendations during its push to protect patients from surprise medical bills.  

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Moving specialty drug administration from hospitals to homes could save $4B per year

Administering specialty drugs in physicians’ offices and patients’ homes instead of in-hospital could improve care and cut healthcare spending in the U.S. by $4 billion each year, according to a Sept. 9 report from UnitedHealth Group.

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Kaiser Permanente will be forced to disclose more under California law

Kaiser Permanente, a large health system based in California, will be forced to follow the same disclosure laws as other healthcare payers and providers in the state thanks to a new law signed by Gov. Gavin Newsom.

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Survey: Consumers aren’t fond of the pharma industry

The reputation of the pharmaceutical industry is tanking among U.S. consumers, the latest Gallup poll reveals.

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How insurers are grappling with million-dollar therapies

New gene therapies are carrying price tags in the millions, leaving insurers scrambling to figure out how to cover them and offer the treatments to enrollees, according to The Wall Street Journal.

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$69B CVS-Aetna deal cleared by court

U.S. District Court Judge Richard Leon has approved the $69 billion acquisition of Aetna by CVS Health, he announced in an opinion on Sept. 4.

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OIG audit reveals Medicare overpaid millions for prescription drugs in hospice care

Medicare Part D overpaid millions of dollars for prescription drugs that should have been covered by the Medicare Part A hospice benefit, according to a recent report from the Office of Inspector General (OIG), which conducted an audit from 2016 payments. In other words, CMS paid twice for the same drugs.

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Purdue Pharma prepares for bankruptcy

Purdue Pharma, the maker of popular opioid OxyContin, is preparing to file for bankruptcy before the end of September if the company doesn’t reach a settlement over thousands of lawsuits against the company for its role in the opioid abuse epidemic, Reuters reported, citing people familiar with the matter.

 

Around the web

CMS finalized a significant policy change when it increased the Medicare payments hospitals receive for performing CCTA exams. What, exactly, does the update mean for cardiologists, billing specialists and other hospital employees?

Stryker, a global medtech company based out of Michigan, has kicked off 2025 with a bit of excitement. The company says Inari’s peripheral vascular portfolio is highly complementary to its own neurovascular portfolio.

RBMA President Peter Moffatt discusses declining reimbursement rates, recruiting challenges and the role of artificial intelligence in transforming the industry.