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 is trending toward pricier outpatient services

An increasing share of hospital services have been performed in an outpatient setting in the past decade, according to a recent analysis from the Health Care Cost Institute—a trend that’s costing patients more every year.

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Death rates by opioid overdose tied to regional disparities in treatment capacity

Too often in the national opioid epidemic, the resources have seemed ample where the need is slim—and vice versa. The hunch has been confirmed by a study conducted at the University of Texas Health Science Center in Houston and published in the Journal of Addiction Medicine.

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Medicaid expansion linked to lower cardiovascular mortality rates

Amid a national debate over whether or not to dissolve the Affordable Care Act entirely or keep parts of the law intact, research presented at the American Heart Association’s QCOR Scientific Sessions on April 5 suggests Medicaid expansion contributed to a significant decline in cardiovascular-related deaths in recent years.

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New Cigna plan caps monthly out-of-pocket insulin costs at $25

Cigna and Express Scripts announced April 3 they’re launching a Patient Assurance Program that will ensure individuals with diabetes pay no more than $25 out-of-pocket for insulin each month.

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There’s a better way to score hospitals with 1 to 5 stars, researchers say

The creators of CMS’s Overall Hospital Quality Star Rating ratings system—aka “Hospital Compare”—intended to present healthcare consumers with an easy, user-friendly way to choose a hospital. However, since the ratings went live in 2016, the system has proven both confusing to consumers and confounding to hospitals.

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Federal judge rejects expansion of association health plans

A federal judge rejected the Trump administration’s efforts to expand access to association health plans March 29, throwing small businesses that rely on those plans into a state of uncertainty, the Washington Post reported.

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Female Ob/Gyns paid $67K less than male colleagues

Women physicians who work in reproductive health for women earn an average $67,000 less per year than men working in the same field. The pay gap cuts across subspecialties within it, such as reproductive endocrinology, and it holds even after adjusting for years of experience, hours worked and other variables.

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1 in 7 patients receive surprise medical bills

Roughly 1 in 7 patients—or 14.5 percent of hospital admissions in the U.S.—experience surprise medical billing despite seeking care at an in-network facility, according to an analysis by the Health Care Cost Institute (HCCI).

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.