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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Savings in Medicare Advantage related to lower spending before beneficiaries enroll

The savings that Medicare Advantage plans can bring to the table may have been over-weighted after a recent study revealed seniors who switch from traditional Medicare plans already have lower healthcare costs before they join an MA plan.

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FDA to end alternative summary reporting

The FDA is putting an end to a program that allowed medical device companies to keep the public in the dark about reports of harm and malfunction. The program, called alternative summary reporting, was established in 1997 and its data has not been publicly available.

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Basing US drug prices on an international reference could save billions

Adopting the prices of other countries could potentially have helped save Medicare part D as much as $72.8 billion in 2018, as drug prices in the U.S. averaged 3.2 to 4.1 times higher after rebates compared to the U.K., Japan and Ontario, Canada, according to a study published in Health Affairs.

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Drug companies will publish prices in TV ads

HHS has finalized a rule that will require drug companies to publish the list prices of drugs in television ads. 

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CMS speeds up Medicaid changes for states that apply

CMS is taking steps to streamline the review process for states that apply for section 1915 waivers and state plan amendments, CMS Administrator Seema Verma announced May 7.  

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Tennessee to ask for Medicaid block granting

Tennessee is poised to become the first state of the union to ask for Medicaid block granting from the Trump administration, Politico reported.

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CVS asks judge to block witness testimony in court battle over its $69B Aetna deal

CVS Health is still facing challenges from its $69 billion merger with health insurance giant Aetna, which closed in late 2018. While the deal was approved by all necessary state regulators and the Department of Justice, a federal judge is still mulling over the deal and looking at potential antitrust problems.

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Aetna to pay $86M in arbitration settlement to HCA Healthcare

One of the nation’s largest health insurers, Aetna, will pay $86 million to HCA Healthcare after a lawsuit stemming from 2015 led to an arbitration trial.

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.