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. 

Healthcare priorities entangled in packed Congress agenda

The congressional to-do list for December is quite long, with the Senate looking to pass major tax overhaul and the looming threat of a government shutdown. Most important for the healthcare industry is the fact that the Affordable Care Act (ACA) and the Children’s Health Insurance Program (CHIP) have become one of the many items fighting for attention on Capitol Hill.

Carolinas-UNC merger under state review

A special committee formed by the University of North Carolina’s board of governors has until Dec. 20 to review the proposed joint venture between the UNC Health Care System and Carolinas HealthCare System.

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Socioeconomically deprived most affected by soaring heart failure rates in UK

Despite increased prevention efforts and longer lifespans, heart failure rates are at a high in the United Kingdom and are continuing to climb, according to new research published in The Lancet.

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What healthcare groups want from ‘new direction’ on CMMI payment models

Fewer electronic health record requirements, smaller payment reforms and changing the definition of financial risk are some of the changes suggested by major healthcare groups in response to the CMS request for information on future models at the Center for Medicare and Medicaid Innovation (CMMI).

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Actuaries to Congress: Repealing individual mandate could threaten insurer solvency

If the Affordable Care Act’s individual mandate is repealed as part of a Republican tax cut plan, premiums will likely rise and insurers will exit the individual market, according to the American Academy of Actuaries.

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Insurers in Massachusetts have to cover birth control without copay under new law

Massachusetts Gov. Charlie Baker signed a law on Nov. 21 to require insurers cover birth control products without copays, allow women to obtain a year’s supply at once and prevent most employers from opting out of contraceptive coverage on moral or religious grounds.

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HHS nominee made millions in pharma

Alex Azar, President Donald Trump’s nominee for HHS Secretary, was paid nearly $2 million in his final year as an executive at pharmaceutical giant Eli Lilly and built a portfolio worth as much as $20.6 million in his nearly 10-year tenure at the company.

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Fighting opioid abuse, lowering drug prices, deregulation are goals of Medicare Part D rule

Several changes to Medicare Advantage and Medicare Part D prescription drug plans have been included in a proposed rule by CMS in an effort to fight opioid abuse among seniors while taking another step towards reducing regulations.

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.