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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MIPS can’t be fixed, MedPAC argues in report to Congress

The Medicare Payment Advisory Commission has released its March 2018 report for Congress, which includes its recommendation to eliminate the Merit-based Incentive Payment System (MIPS) after only a one year of clinician reporting to the program.

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Prices and labor costs, not overutilization, set U.S. healthcare system apart

A new study published in JAMA challenges some of the more common explanations for why the U.S. spends more on healthcare than other high-income countries, finding the U.S. isn’t an outlier on measures like utilization, share of primary care physicians or social services spending.

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CVS, Aetna shareholders approve $69B acquisition

Shareholders for both CVS Health and Aetna overwhelmingly approved the proposed $69 billion deal for CVS to acquire the health insurer, bringing the merger one step closer to completion.

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.

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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.

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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.

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Around the web

Cardiovascular Business
Boston Scientific enters renal denervation market with acquisition worth up to $540M

Boston Scientific has announced another significant M&A deal, scooping up an Israeli medtech company focused on RDN technology. 

Radiology Business
Shift toward imaging outside the hospital could save billions

Harvard’s David A. Rosman, MD, MBA, explains how moving imaging outside of hospitals could save billions of dollars for U.S. healthcare.

Cardiovascular Business
FDA announces catheter recall for Johnson & Johnson PFA system due to stroke risk

The recall comes after approximately 3% of patients treated with the device during the early stages of its U.S. rollout experienced a stroke or transient ischemic attack following surgery. The expected stroke rate is closer to 1%, the FDA explained.