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 proposes to cover new cancer therapy

CMS has proposed covering a new form of cancer therapy, CAR T-cell therapy, under Medicare. The proposal would create a uniform standard of covering the treatment, which uses a patient’s own immune system to fight the disease.

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Unnecessary ED visits for chronic conditions cost $8.3B

Emergency department (ED) visits for people with at least one of six prevalent chronic conditions contributed to approximately 50 percent of all annual visits at nearly 750 hospitals in 2017. 

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HHS launches new model for ambulatory services to serve outside the ED

HHS and the Center for Medicare and Medicaid Innovation (CMMI) introduced a new payment model for emergency ambulance services that would allow Medicare beneficiaries to receive care on the scene or at lower acuity sites, such as urgent care clinics.

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Higher employee satisfaction associated with improved patient care

Veterans Affairs Medical Centers (VAMC) with higher levels of employee organizational satisfaction also tend to have higher safety scores and patient satisfaction ratings, according to new research published in the American Journal of Medicine.

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How PBMs will fare without rebates

The Trump administration’s recent proposal to eliminate rebates between drug manufacturers and pharmacy benefit managers (PBMs) is not a big surprise to those who have been paying attention to the rhetoric of CMS and HHS officials, but the impact of swapping rebates for direct discounts is still a big question.

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Texas is trying to deal with surprise medical bills

Surprise medical bills, where patients get a sky-high bill in the mail weeks after they received care, are a major issue for consumers. But one state that has tried to help alleviate the pain of the bills has been overwhelmed.

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Former Google head: AI will impact healthcare jobs

Former Google China President Kai-Fu Lee believes the rise of AI “will come in waves,” he told FOX Business. Lee said healthcare is one of the industries that will benefit the most from AI. 

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Per-person healthcare spending reaches all-time high

Healthcare spending per person rose to an all-time high in 2017 for those covered by employer-sponsored insurance, according to the Health Care Cost Institute (HCCI). Average healthcare spending per individual rose 4.2 percent to $5,641, including medical and pharmacy claims.

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.