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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Illinois hospitals’ tax exemptions at risk in court case

According to the State Journal-Register, the court case rests on whether the 2012 statute makes a clear requirement that the hospitals’ charitable services at least equal the value of what they would otherwise pay in taxes. The plaintiff, Constance Oswald, has argued the law replaces the standard charitable requirement and therefore violates the Illinois Constitution and previous court rulings.

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Anthem to buy palliative care provider Aspire

After months of sitting out of the flurry of mergers and acquisitions between insurers and providers, Anthem has made its first move by announcing it will acquire Aspire, the largest non-hospice, community-based palliative care provider in the U.S.

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Hospital debt is big business for banks and law firms

The $20 billion in tax-exempt bonds not-for-profit hospitals sell on average every year can lead to $300 million going to banks and law firms handling debt deals—with those costs potentially encouraging hospitals to raise prices even as they’re exempt from paying taxes to their communities.

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Mayo Clinic sells off health plan to Wisconsin’s WEA Trust

It marks the not-for-profit WEA Trust’s first entry into the private employer insurance market, having offered group coverage for Wisconsin state employees since its founding in 1970.

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‘Right-to-try’ legislation approved by Congress

The House approved legislation to allow terminally ill the “right to try” experimental drugs not yet approved by the FDA on a largely partisan vote, sending the bill to a supportive President Donald Trump.

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HCA eyeing purchase of Envision with private equity partner

Reuters reports HCA’s proposal would essentially reverse Envision’s 2016 merger with AmSurg. The rest of the $5.1 billion Envision would be taken over by KKR.

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UnitedHealth: Medicaid more cost-effective than ACA plans

UnitedHealth said it costs an average of $9,400 annually to cover a low-income, subsidized enrollee on the marketplace with $7,000 of that cost falling on the federal government. For someone eligible for Medicaid thanks to the Affordable Care Act (ACA), the overall cost is $5,400—with $5,100 coming from federal funds.

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HHS proposing stripping Title X funding from clinics providing, referring abortions

Direct federal funding for abortions has been prohibited by Congress for decades, but conservative lawmakers have sought to deny all federal funding to groups like Planned Parenthood for having any involvement in abortion services.

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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