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. 

Immigration status impacts Medicaid enrollment in non-ACA-expansion states

Does immigration status affect Medicaid enrollment through the Affordable Care Act (ACA), both in states that expanded services and those that did not? Recent research found no differences in Medicaid coverage between mixed-status households and non-mixed-status households. But in states that did not expand Medicaid, coverage rates were lower for individuals in mixed-status households compared to the non-mixed-status population. 

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HIMSS18: Alpha II’s Tim Mills on what providers will soon want from RCM software

This year, providers may be struggling with meeting deadlines on reporting for the Merit-based Incentive Payment System (MIPS) and avoiding a negative payment adjustment. In a few years, however, they’ll expect solutions to more complicated issues surrounding value-based reimbursement, according to Tim Mills, chief growth officer at revenue cycle, coding and billing software company Alpha II.

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Senators ask what’s holding up price transparency in healthcare

A group of U.S. senators has sent a letter to dozens of healthcare industry groups asking for more information on what price and quality information is available to consumers and what regulations may be getting in the way of greater price transparency.

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Association health plans could increase instability on ACA markets

The Trump administration’s plans to expand the availability of association health plans could siphon up to 4.3 million people from the individual and small group insurance markets over the next five years, raising premiums on those who remain in plans which are compliant with the Affordable Care Act (ACA).

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MGMA: Medical groups opposed to mandatory APMs

A large majority of medical group professionals responding to a poll from the Medical Group Management Association (MGMA) was opposed to mandatory participation in alternative payment models in Medicare, a policy CMS has been moving away from under President Donald Trump.

Rhode Island’s Lifespan in talks for collaboration with Partners HealthCare, Care New England

The previously proposed merger between Boston’s Partners Healthcare and Care New England, one of the largest systems in Rhode Island, may have a third partner: Lifespan, the operator of Rhode Island Hospital.

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New opioid legislation includes 3-day limit on initial prescriptions

A group of senators has introduced a new bill aimed at fighting opioid abuse and addiction, including limits on initial prescriptions for acute pain and an expanded role for non-physician practitioners in prescribing buprenorphine.

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Why MIPS should be replaced

In an article for Health Affairs, a group of fellows at the Brookings Institution made the case for replacing the Merit-based Incentive Payment System (MIPS) with “stronger incentives” to move into alternative payment models (APMs).

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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