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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More clinicians will be exempt from MIPS in 2018, won’t be able to opt in

CMS has finalized the rule for the second year of Medicare Access and CHIP Reauthorization Act’s (MACRA) Quality Payment Program (QPP), raising the low-volume threshold for the Merit-based Incentive Payment System (MIPS) but not allowing clinicians the option to participate if they don’t meet the minimum requirements.

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5 things about the final OPPS rule and hospitals’ lawsuit over 340B change

CMS released its final hospital outpatient prospective payment system (OPPS) rule for 2018, which included a significant cut to drug payments to hospitals which use the 340B drug discount program. The result was the quick threat of a lawsuit from three major medical groups.

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10 things Democrats want from the next HHS Secretary

The top Democrats on the Senate’s finance and health committees have outlined 51 criteria for judging President Donald Trump’s next nominee to run HHS, with many of their priorities going against the policies touted by Trump and former HHS Secretary Tom Price, MD.

ACA 'sabotage’ more difficult to fight than repeal

While supporters of the Affordable Care Act (ACA) were able to keep the law from being repealed and replaced in 2017, helping people sign up for coverage while the Trump administration has made deep cuts to enrollment efforts will be more difficult.

Trump’s opioid panel could change patient surveys, prescriber training

The commission on combating opioid addiction and abuse set up by President Donald Trump will issue its final recommendations on Nov. 1, with a draft copy laying out policies that could affect everything from patient surveys to reimbursement for addiction treatment.

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CMS proposes letting states change ACA’s essential health benefits, medical loss ratio

The definition of “essential health benefits” which Affordable Care Act-compliant health plans have to cover would be up for states to decide under a rule proposed by CMS, echoing similar provisions which had been included in Republican legislative efforts to repeal and replace the ACA.

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6 states could be out of CHIP funds by January

Federal funding for the Children’s Health Insurance Program (CHIP) expired at the end of September, and with no quick renewal expected from Congress, states are on their own to keep the program afloat. According to a report from the Georgetown University Center for Children and Families, six states won’t be able to do so past early January.

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Trump declaration of public health emergency on opioids could impact physicians

President Donald Trump followed through on a months-old promise to declare a national public health emergency on the opioid addiction epidemic, which could increase access to addiction treatment and additional training for physicians prescribing opioids.

Around the web

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.

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. 

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