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. 

Hospital recommends fundraising to patient who couldn’t afford heart transplant

In another sign that the cost of healthcare is too high, one hospital system based in Grand Rapids, Michigan, denied a heart transplant to a woman and recommended she try to raise $10,000.

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CMS proposes new Medicare prescription drug rules

CMS proposed several new policies for 2020 that aim to lower prescription drug prices by revising how Medicare plans can cover medicines and negotiate prices.

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CVS-Aetna deal approved by all regulators

CVS Health received the final approval for its $69 billion merger with the nation’s third-largest health insurance provider, Aetna, on Nov. 26. CVS expects the deal to close Nov. 28, according to a new public filing.

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CMS reapproves Medicaid work requirements in Kentucky

After a federal judge blocked Kentucky’s Medicaid work requirements from going into effect earlier this year, CMS reapproved the program on Nov. 20.

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Health insurer based benefits on sleep habits

Health insurers are using new methods to monitor consumers enrolled in their plans, as one person discovered when his sleep habits unknowingly played a role in the benefits he received from his provider, ProPublica reported.

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Lawmakers to introduce bill to lower drug prices

Senator Bernie Sanders (I-Vt.) and U.S. Representative Ro Khanna (D-Calif.) are planning to introduce a bill that aims to “drastically” lower prescription drug prices once Congress is back in session.

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CVS-Aetna deal now likely to close after Thanksgiving

While the $69 billion merger between CVS Health and Aetna has moved through the regulatory review process, CVS executives now expect the deal to close after Thanksgiving, according to a new public filing. Executives previously anticipated the transaction would be completed before the holiday.

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Wildfires lead HHS to declare public health emergency in California

Several wildfires in California led HHS Secretary Alex Azar to declare a public health emergency in the state on Nov. 13. The announcement allows CMS providers, suppliers and beneficiaries flexibility to meet emergency needs.

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.