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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CMS asks for input on selling insurance across state lines

CMS is looking for public input on how to regulate and operate the sale of health insurance coverage across state lines. The agency published a request for information (RFI) on March 6 with a public comment period of 60 days.

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AMA, states sue Trump administration over Title X changes

The American Medical Association (AMA) filed suit against the Trump administration after it finalized changes to Title X that impact family planning providers.

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Free-standing ED prices substantially higher than other care settings

Consumers are more into convenient options when it comes to just about any industry, but in healthcare, the preference has led to national growth in freestanding emergency departments (FSEDs).

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Patients more likely to switch hospitals to give birth if they receive a surprise bill

Mothers who gave birth twice were more likely to switch to another hospital after the first birth if they received a surprise bill following care, according to a recent study published in Health Affairs.

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After pricing pushback, Eli Lilly will sell a half-price insulin drug

Drug manufacturer Eli Lilly plans to offer a half-priced version of its insulin medication Humalog, the company announced March 4.

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Blue Cross Blue Shield Association proposes health insurance improvements

The Blue Cross Blue Shield Association (BCBSA) published three proposals that would lower premiums by one-third for Obamacare insurance coverage and expand access to coverage for more than 4 million additional people.

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Marketplace insurers deny many claims—and enrollees seldom push back

Health insurers selling their services through Healthcare.gov denied nearly one-fifth of claims in 2017. And only a tiny fraction of the affected consumers—less than one-half of one percent—appealed the decisions.

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Uninsured rate remains below 10% as more choose high-deductible plans

Nearly 30 million individuals of all ages in the U.S. were uninsured during the first nine months of 2018. This figure represents a little over 9 percent of the population, and it’s similar to the uncovered headcount from 2017. Still, it’s a notable improvement from 2010, when the Affordable Care Act was nascent and 19 million more people lacked coverage.

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.