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 finalizes changes to the ACO program

CMS has finalized changes to the Medicare Shared Savings Program (MSSP) that “dramatically redesigns and sets a new direction” for Medicare accountable care organizations (ACOs). The final rule, as outlined in the proposed rule announced in August, will force ACOs to take on more risk at a quicker pace.

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Cigna, Express Scripts close $67B merger

After a delay, Cigna has closed its $67 billion acquisition of Express Scripts, the company confirmed on Dec. 20.

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Value-based care made major headway in 2017

The shift to value-based care made significant headway in 2017, according to a new survey from the Health Care Transformation Task Force that found nearly half of their business was in value-based payment arrangements by the end of the year.

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3 in 10 Americans delay healthcare due to high costs

Roughly 3 in 10 Americans don’t seek medical care because they can’t afford it, according to a recent Gallup poll.

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CMS to scrutinize conflicts of interest among accrediting organizations

CMS wants to take a closer look at the financial relationships of accrediting organizations (AOs) that survey Medicare-certified healthcare providers.

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Judge tells CVS, Aetna to keep operations separate during antitrust review

A federal judge who has been reviewing the $69 billion merger between CVS Health and Aetna has told the two companies to keep some operations separate during the ongoing antitrust process, The New York Times reported.

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$67B Cigna-Express Scripts deal approved by final regulator

Cigna received its final approval from regulators for its $67 billion acquisition of Express Scripts. New Jersey approved the transaction, clearing the way for the deal to close, according to a public filing from Cigna.

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Drugmakers Pfizer and Glaxo to combine business units

Drug manufacturing giants Pfizer and GlaxoSmithKline will combine their consumer healthcare units in a separate joint venture that will be the world’s largest seller of over-the-counter medicines.

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.