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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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.

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Baylor Scott & White, Memorial Hermann announce merger plans

Baylor Scott & White Health and Memorial Hermann Health System announced plans to merge their systems on Monday, Oct. 1.

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The Week: US edging toward ‘nursing crisis’

The U.S. is edging ever closer to a nursing crisis, news magazine The Week has reported, citing staffing shortages, security concerns and insufficient pay among the reasons American RNs are becoming restless.

Immigrants’ private insurance premiums exceed amount they receive in benefits

Immigrants to the U.S. accounted for nearly 13 percent of premiums paid to private insurers in 2014, according to a study published Oct. 1 in Health Affairs. But they’re spending more on those premiums than they’re receiving in benefits, creating a deficit that’s hard to ignore as the country wrestles with immigration policy.

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UnitedHealth Group acquires Genoa Healthcare for $2.5B

UnitedHealth Group, the U.S.’s largest health insurer, bought pharmacy company Genoa Healthcare for $2.5 billion, Bloomberg reports.

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HHS Sec. Azar slams Medicare for All

Despite growing support for a Medicare for All system among Democrats, HHS Secretary Alex Azar blasted such an idea during a speech in Tennessee this week, The Hill reported.

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.