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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Verma defends Medicaid work requirements after thousands lose coverage

CMS Administrator Seema Verma went to bat for Medicaid work requirement programs, which have been implemented or approved in a handful of states, even as thousands of beneficiaries are on course to lose healthcare coverage as a result of these rules.

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WellCare to buy Aetna’s Part D biz in CVS deal divestiture

CVS Health’s $69 billion acquisition of health insurance giant Aetna is not going to complete without divestments. WellCare Health Plans, a Tampa-based managed care company, has agreed to acquire Aetna’s entire Medicare Part D prescription drug plan business, which encompassed 2.2 million members as of June 30.

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Hospital patients in outpatient settings are sicker, poorer

Medicare patients who receive hospital outpatient care are more likely to be poorer and have more severe chronic conditions compared to those treated in an independent physician office, according to a study commissioned by the American Hospital Association.

Medicaid spending hit $581B in 2016

In 2016, Medicaid spending reached $581 billion—the highest level ever for the federal program—and covered an estimated 72 million beneficiaries. Over the next decade, spending is projected to rise 5.7 percent a year, topping $1 trillion by 2026.

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PBMs blame insurers for high drug prices

Pharmacy benefit managers (PBMs)—the industry middlemen that negotiate drug prices—are passing on nearly all their savings to insurance providers, according to Terry Wilcox, co-founder and executive director of advocacy organization Patients Rising. His op-ed for The Hill placed the blame of high costs squarely on insurers.

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Another industry group speaks out against CVS-Aetna deal

The Association of American Physicians and Surgeons (AAPS) wrote a letter to Attorney General Jeff Sessions in opposition to the $69 billion merger of CVS Health and Aetna.

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More industry groups oppose changes to ACO program

Nine industry groups have joined in opposition to CMS’s proposed changes to the Medicare Shared Savings Program.

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Alzheimer’s and dementia cases will double by 2060

As the American population ages, the number of cases of Alzheimer’s disease and other forms of dementia is set to explode, according to the CDC.

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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