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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‘Inevitability of consolidation’ motivated nonprofit Mission Health to open talks with HCA

For-profit hospital giant HCA has entered into discussions to acquire Mission Health, a nonprofit six-hospital system based out of Asheville, North Carolina, in a deal Mission admitted may result in some jobs being eliminated.

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Top priorities for CMS include Stark law, ACA mandate changes

CMS Administrator Seema Verma, MPH, offered some hints at the agency’s priorities in its annual rulemaking for Medicare this year, suggesting a slew of new policies on price transparency, interoperability and physician self-referral laws.

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CMS would exempt 17 Medicaid managed care states from most access monitoring

In a proposed rule, CMS would loosen requirements for states with Medicaid managed care programs on analyzing and monitoring access to care, a move the agency said would provide additional relief on “burdensome” regulations finalized by the prior administration.

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Advocate-Aurora merger gets final approval

Downers Grove, Illinois-based Advocate Health Care and Milwaukee’s Aurora Health Care have gotten the final approval needed to close their merger, which will create the 10th largest nonprofit, integrated health system in the country.

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Why ACA stabilization funds were kept out of the omnibus spending bill

The $1.3 trillion omnibus spending bill released on March 21 includes boosts in funding for HHS, the National Institutes of Health and efforts to fight opioid abuse. What was left out were measures aimed at stabilizing the Affordable Care Act (ACA) exchanges with funding for additional reinsurance and restoring the law’s cost-sharing reduction subsidies.

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Maryland all-payer hospital program saves $586M in 3 years

The global budgeting, all-payer program adopted for most of Maryland’s hospitals has succeeded in keeping the growth in hospital revenue and Medicare expenditures below the rest of the nation through its first three years, while also reducing readmissions and complications.

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Cigna CEO on CNBC: Express Scripts acquisition about ‘capabilities, reach, quality, affordability’

The proposed $67 billion acquisition of pharmacy benefits manager (PBM) Express Scripts by insurer Cigna isn’t just about acquiring a PBM, according to Cigna CEO David Cordiani, as he defended the deal from the lukewarm response from Wall Street on CNBC’s “Mad Money.”

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Partners-Care New England merger likely to raise premiums

A study from the Rhode Island Office of the Health Insurance Commissioner said the state’s residents would see increases in insurance premiums if Boston-based Partners Healthcare acquires Care New England, thanks to Partners likely using its regional market clout to gain better prices from insurers.

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.