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. 

Hospitals, health plans incorrectly omitted from Illinois ACA exchange

Information on Illinois’ health insurance exchange may be incomplete or inaccurate as shoppers prepare for the fourth open enrollment period.

6 things to know about consumers’ healthcare policy priorities

A new poll from the Kaiser Family Foundation asked what healthcare policies they’d most like to see Congress and the next president address—and making changes to the Affordable Care Act (ACA) wasn’t the most popular answer.

Largest Medicaid insurer in Mass. stops taking new members

Neighborhood Health Plan (NHP), a Medicaid managed care subsidiary of Boston-based Partners Health Care, is suspending enrollment of new members after $241 million in losses since 2014.

How Purdue Pharma stopped insurer efforts to limit OxyContin prescriptions

In 2001, when West Virginia noticed a rise in deaths due to oxycodone, the active ingredient in OxyContin painkillers, it tried requiring prior authorization for the drug. But its manufacturer, Purdue Pharma, wrecked the plan by offering rebates to a pharmacy benefits manager.

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Vermont approves all-payer, ACO-like system

The state of Vermont is moving ahead with its first-in-the-nation all-payer model emphasizing value-based care.

Benchmark ACA premiums up 25% for 2017

The average monthly premium for the second-lowest cost silver plan on the Healthcare.gov marketplace will go up by 25 percent for 2017, according to HHS, the largest year-over-year jump in prices since the marketplace opened.

Fewer physicians, pharmacies faced DEA investigations as opioid addictions grew

A Washington Post investigation said the Drug Enforcement Administration (DEA) dropped its aggressive efforts against pharmacies, physicians, distributors and manufacturers to curb opioid abuse, mostly thanks to pressure from drug companies.

Hospital, insurer, pharma lobbyists push back against public option

The calls for a government-run insurance option on the Affordable Care Act’s insurance exchanges are being met with resistance from groups that had supported the law.

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.