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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Reuters: Civitas considering potential sale

Civitas Solutions, a home- and community-based healthcare services provider based in Boston, is considering a potential sale and strategic alternatives, according to Reuters, which cited people familiar with the matter.

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Kaiser: Employer-sponsored health plan premiums are rising

More than half of U.S. employers are offering their staffers health insurance, according to the 2018 Kaiser Family Foundation (KFF) Employer Health Benefits Survey—but annual family premiums are up 5 percent this year, and premiums for individual coverage rose a similar 3 percent.

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CVS will keep Aetna headquarters for next decade

CVS Health will keep Aetna’s headquarters in Hartford, Connecticut, for at least 10 years following the completion of its $69 billion merger with Aetna, The Hartford Courant reported.

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CMS’s aim to cut documentation will be a payment cut

When CMS proposed several changes to the Physician Fee Schedule and Quality Payment Program in July, it was under the guise that the agency was knocking off burdensome documentation requirements for physicians. However, the agency’s own proposal states documentation time won’t actually be reduced by much—but the changes will likely come with a payment rate cut.

FDA raids California offices of e-cigarette maker

The Food and Drug Administration conducted a surprise inspection at the offices of Juul Labs—a large e-cigarette maker—last week and walked away with more than a thousand pages of documents related to the company’s marketing and sales practices, The New York Times reported.

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Humana and Heritage launch MA partnership

Humana is collaborating with Heritage Provider Network, a large physician-led value-based care organization, on a value-based agreement to offer coordinated, patient-centered care to Humana’s Medicare Advantage members in Southern and Central California.

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Trump says he’ll ‘always fight’ for people with pre-existing conditions; DOJ’s stance says otherwise

As the U.S. Department of Justice works to help nullify the Affordable Care Act, recent comments by President Donald Trump directly contradict his administration’s stance.

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MA provider shells out $270M for False Claims Act settlement

Medicare Advantage (MA) provider HealthCare Partners Holdings has agreed to pay $270 million to resolve its False Claims Act liability after providing inaccurate information that caused MA plans to receive inflated Medicare payments, the Department of Justice announced this week.

Around the web

With generative AI coming into its own, AI regulators must avoid relying too much on principles of risk management—and not enough on those of uncertainty management.

Cardiovascular devices are more likely to be in a Class I recall than any other device type. The FDA's approval process appears to be at least partially responsible, though the agency is working to make some serious changes. We spoke to a researcher who has been tracking these data for years to learn more. 

Updated compensation data includes good news for multiple subspecialties. The new report also examines private equity's impact on employment models and how much male cardiologists earn compared to females.

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