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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Mayo Clinic receives $200M gift

A philanthropist has given $200 million to Mayo Clinic in what is the largest-ever donation to the nonprofit hospital system.

NYT: Hospital mergers lead to higher costs for patients

On the surface, hospital mergers may seem like an opportunity to create benefits for consumers, including more resources for top-notch care and lower costs. However, cheaper prices aren’t a likely outcome, according to an analysis by The New York Times.

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CMS to allow Medicaid mental health demonstrations

CMS sent state Medicaid directors an email on Nov. 13 announcing new opportunities to design service delivery systems for treating mental health. The announcement eases previous prohibitions against using Medicaid funding to pay for short-term residential treatment in an institution for mental disease.

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Envision reaches contract agreement with Cigna

Envision Healthcare has reached a new statewide agreement with Cigna Healthcare of Arizona. The multiyear agreement ensures Envision’s clinicians are in-network.

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FDA will strengthen expanded access program for non-approved treatments

FDA Commissioner Scott Gottlieb, MD, has signaled that the agency will strengthen its expanded access (EA) program to enable more patients to access investigational medical products and treatments for serious or life-threatening diseases.

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CMS proposes to reform Medicaid managed care

CMS proposed regulatory reform of the Medicaid managed care program on Nov. 8, giving states more freedom over network-adequacy standards.

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FTC accuses Florida agency of selling $100M in fraudulent insurance plans

A federal judge has temporarily shut down Florida-based company Simple Health Plans after the Federal Trade Commission accused the agency of collecting more than $100 million in fraudulent insurance payments and leaving its enrollees with thousands of dollars in medical debt.

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PwC: What the midterm shakeup means for healthcare

After holding control of Congress for eight years and attempting to eradicate the Affordable Care Act dozens of times, Republicans lost the majority in the House on Nov. 6 during the midterm elections. The partisan shakeup could have several impacts on the nation's healthcare agenda.

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.