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. 

ACA stabilization package would boost coverage, lower premiums on individuals

A pair of bills to fund the Affordable Care Act (ACA)’s cost-sharing reduction (CSR) subsidies and create a new reinsurance program would lower monthly premiums for exchange plans by 20 to 40 percent and boost enrollment by 3.2 million people. Conservative groups, however, call the legislation a “bailout” for insurance companies.

CMS didn’t reject ‘our approach’ to ACA, argues Idaho’s governor

When CMS told Idaho it couldn’t move ahead with plans to allow health insurers to offer coverage which doesn’t comply with the Affordable Care Act (ACA), Idaho Gov. Butch Otter didn’t see it as a rejection but rather the start of a negotiation.

Medical device industry may see up to 5% growth

Moody’s Investors Service has upgraded the financial outlook for the medical products and device industry from stable to positive, predicting that “continued product innovation” and synergies from acquisitions will drive growth of earnings before interest, depreciation and amortization (EBITDA) of between 4 and 5 percent over the next 12 to 18 months.

Thumbnail

HIMSS18: What providers have learned, what comes next for the Quality Payment Program

Clinicians have until March 31 to submit 2017 performance data for the Quality Payment Program established after passage of Medicare Access and CHIP Reauthorization Act (MACRA). HealthExec spoke with Beth Houck, MBA, the vice president of client services at value-based program compliance and analytics software company SA Ignite, at the HIMSS18 conference in Las Vegas.

Thumbnail

CMS rejects Idaho’s plans to expand non-ACA-compliant insurance

Idaho’s plan to allow health insurers to offer coverage which doesn’t comply with the Affordable Care Act (ACA) would result in CMS fining insurance companies and taking over the state’s role in enforcing the law, essentially denying the state’s proposal to violate the ACA—but also offering the state some guidance on how it could approve the plans in the future.

Cigna to buy Express Scripts for $67B

Cigna announced this morning it will buy Express Scripts in a deal worth a total of $67 billion. The health insurer will assume $15 billion in debt from the pharmacy benefits manager (PBM) in addition to the $52 billion stock-and-cash transaction.

Massachusetts officials give thumbs-up to Beth-Israel-Lahey merger

A potential merger of 13 hospitals in Massachusetts, led by Beth-Israel Deaconess Medical Center and Lahey Health, has been endorsed by state health officials, claiming it will improve services for patients.

Thumbnail

HIMSS18: 6 key data points from US leadership, workforce survey

As the healthcare professionals touch down in Las Vegas for the 2018 Healthcare Information and Management Systems Society (HIMSS), the organization released its annual survey of the marketplace. HIMSS published the 2018 U.S. HIMSS Leadership and Workforce Survey on March 6, which examines trends in employment, technology and expectations.

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.