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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Ascension signs definitive agreement to acquire Chicago’s Presence Health

Three months after the transaction was first announced, St. Louis-based Ascension Health and Chicago’s Presence Health have signed a definitive agreement for Presence to join Ascension’s existing joint venture in Illinois, AMITA Health.

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HHS Secretary supports CDC researching gun violence

For two decades, the Centers for Disease Control and Prevention (CDC) has supposedly been blocked from conducting research into the health effects of gun violence by a budget amendment. HHS Secretary Alex Azar has a different opinion, telling members of Congress Thursday he would allow the CDC to conduct research which doesn’t veer into advocacy.

$1B Medicare Advantage fraud case against UnitedHealth can proceed

The U.S. Department of Justice (DOJ) can move forward with a lawsuit alleging UnitedHealth Group wrongly collected more than $1 billion through Medicare Advantage by finding conditions to increase a patient’s risk adjustment payment from CMS.

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FTC approves Advocate-Aurora merger

The proposed merger between Downers Grove, Illinois-based Advocate Health Care and Milwaukee’s Aurora Health Care now has the blessing of the Federal Trade Commission and regulators in Illinois, leaving regulatory approval in Wisconsin as the final hurdle for creating the 10th largest nonprofit health system in the U.S.

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AHA to CMS: Delay application deadline for new bundled payment model

Providers have until March 12 to apply for CMS’s new Bundled Payments for Care Improvement (BPCI) Advanced model, though the program was only unveiled on Jan. 9. Considering the details CMS has given about the model, that’s not enough time for hospitals to decide whether to participate, according to the American Hospital Association (AHA).

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Health spending growth will accelerate through 2026

The growth in health expenditures nationwide is expected to average 5.5 percent annually through 2026, with the aging population driving more rapid annual growth in Medicare.

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HHS Secretary defends cuts to department in budget proposal

In his first congressional testimony since being confirmed as HHS Secretary, Alex Azar argued the department’s proposed budget would extend the life of Medicare while making HHS more efficient by cutting nearly $18 billion in funding.

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ER expenditures for privately insured increased faster than Medicare, Medicaid

Between 1996 and 2015, the number of emergency department (ED) visits per individual paid for by Medicare increased at a greater rate than those paid for by private insurance or Medicaid. The annual increases in per-visit expenditures, however, were greater for private insurance than either of the federal programs.

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.