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. 

California legislature ramps up transparency pressure on Kaiser Permanente

Amid a standoff between 85,000 California-based workers at Kaiser Permanente and the health system over contract negotiations, the California legislature has ramped up the pressure against the nonprofit healthcare services organization.

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HHS revamps fight to publish drug prices in TV ads

HHS is fighting back after a legal decision blocked the agency’s rule to require drugmakers to publish the list prices of prescription medications in television ads.

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Signify Health and Remedy Partners to merge

Signify Health and Remedy Partners, two portfolio companies of private equity firm New Mountain Capital, have signed an agreement to merge.

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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.

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.