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.

‘A huge win’: CMS significantly increases Medicare payments for cardiac CT
CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.
Kentucky AG launches criminal probe after conscious man nearly has organs harvested
The incident happened three years ago when Anthony Hoover was declared brain-dead on his medical record, only to wake up on the operating room table moments before his organs were harvested. The incident has spurred a criminal investigation by Kentucky's attorney general.
FDA announces Class I recall of ventilators after 3 patient injuries
An unexpected nickel coating on the breathing circuits of Percussionaire Phasitron 5 ventilators is being blamed for the recall. The FDA is asking providers to stop using them immediately.
FDA clears AI tool that flags signs of heart disease in chest CT scans
The newly cleared offering, AutoChamber, was designed with opportunistic screening in mind. It can evaluate many different kinds of CT images, including those originally gathered to screen patients for lung cancer.
Stewardship Health sale to private equity finalized for $245M
The physician group, once part of Steward Health Care, has been rebranded as Revere Medical.

Single-payer isn’t California’s only option for universal healthcare

A legislative committee in California is hearing proposals about how to achieve the goal of universal healthcare in the state, with advocates looking for inspiration in Canadian, British and German models.

February 6, 2018

Blue Cross Blue Shield: Reinsurance needed to bolster ACA markets

The Blue Cross Blue Shield Association said there’s an “urgent” need for Congress to fund additional reinsurance for companies offering coverage on the Affordable Care Act (ACA), saying with the individual mandate gone beginning in 2019, some action is required to keep premiums from increasing as insurers try to manage a sicker risk pool.

February 5, 2018

Indiana becomes 2nd state approved for Medicaid work requirements

Work requirements have been added to Indiana’s Medicaid program, making it the second state to mandate participation in “community engagement” activities since CMS issued guidelines to states on including those provisions in Section 1115 Medicaid waivers.

February 5, 2018

ACA repeal not on Republican agenda for 2018

The priorities for Republicans in Congress this year don’t appear to include another attempt at repealing and replacing the Affordable Care Act (ACA), though some are publicly urging the party to take another shot after several failed attempts in 2017.

February 2, 2018

Justice Department requests more info on CVS-Aetna merger

The $69 billion proposed acquisition of Aetna by CVS Health remains under review by the Department of Justice (DOJ), which requested the companies provide more information on their merger agreement.

February 2, 2018

How Idaho’s insurance plan would violate ACA

The Idaho Department of Insurance has announced it will allow insurers to sell plans which don’t comply with regulations established by the Affordable Care Act (ACA), which could mean the return of plans that deny coverage based on pre-existing conditions, charge higher premiums based on health status and place lifetime or annual caps on benefits.

February 2, 2018

5 things to know about proposed MA rates, Part D changes for 2019

CMS has released its proposed rule covering rates in Medicare Advantage (MA) and changes to Medicare Part D for 2019, expanding the definition of health-related supplemental benefits and putting limits on opioid prescriptions for beneficiaries.

February 2, 2018

Hospitals can expect 7.35% increase in drug prices

Between July 1, 2018, and June 30, 2019, health systems should expect pharmaceutical prices to jump up by 7.35 percent, a slightly lower increase than in recent years as fewer products see “exorbitant” price hikes and costs moderate for high-priced hepatitis C drugs.

February 1, 2018

Around the web

Cardiovascular Business

Q&A: Why are cardiovascular devices involved in so many recalls? FDA policies may be to blame

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.

Cardiovascular Business

Cardiologist compensation still rising, especially in invasive and interventional cardiology

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.

Cardiovascular Business

FDA’s tirzepatide decision creates uncertainty for patients—and leads to a lawsuit

When drugs are on the FDA’s shortage list, outsourcing facilities can produce their own compounded versions. When the FDA removed tirzepatide from that list with no warning, it created a considerable amount of chaos both behind the scenes and in pharmacies all over the country.

Policy & Regulations

‘A huge win’: CMS significantly increases Medicare payments for cardiac CT

Kentucky AG launches criminal probe after conscious man nearly has organs harvested

FDA announces Class I recall of ventilators after 3 patient injuries

FDA clears AI tool that flags signs of heart disease in chest CT scans

Stewardship Health sale to private equity finalized for $245M

Around the web