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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CDC director denies report of ‘banned words’ in budget documents

The Centers for Disease Control and Prevention (CDC) disputed a report in the Washington Post that seven words or phrases, including “fetus,” “transgender” and “science-based,” had been banned from the agency’s budget documents, while other officials said the motivation was to avoid words that could limit chances of obtaining funding from Congress.

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Which states would see the largest cuts due to 340B changes

CMS’s move to cut Medicare payments made through the 340B drug discount programs would see the biggest impact in California, New York and North Carolina, according to an analysis by Avalere Health, though for most hospitals it will reduce their total Part B revenue by less than 5 percent.

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House Republicans introduce plan to delay ACA taxes

The Affordable Care Act’s taxes on health insurance, high-cost health plans and medical devices would be delayed under a series of bills introduced by House Republicans, with the Medical Imaging & Technology Alliance (MITA) quickly coming out in support of suspending the device tax.

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Democrats ask for extension of ACA open enrollment

Two Senate Democrats have asked CMS and HHS to make a last-minute extension of the open enrollment period for the Affordable Care Act (ACA)’s insurance exchanges, arguing the Dec. 15 deadline will leave too many interested customers either without health coverage or automatically enrolled into plans which “may no longer be the best choice for their families.”

Medicare cuts may be a priority for Congress in 2018

With Republicans in Congress confident they’ll pass a tax cut bill before the end of the year, the question of what their top legislative priority should be in 2018 is up for debate, with some favoring a focus on cuts to federal programs like Medicare.

Insurers warn individual mandate repeal will raise premiums, drive more away from ACA markets

Health insurers expect the repeal of the Affordable Care Act (ACA)’s individual mandate will make the individual insurance market worse, particularly for customers who don’t have employer-sponsored coverage but make too much money to receive subsidies to lower their premiums.

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ACA funding bills would cancel out hikes from repealing individual mandate

The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

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AHA to MedPAC: Eliminating, changing MIPS would confuse providers

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

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.