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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Aetna threatened to leave ACA exchanges if DOJ tried to block Humana deal

A letter from Aetna CEO Mark Bertolini obtained by the Huffington Post appears to contradict the insurer’s stance that pulling out of 11 Affordable Care Act (ACA) exchanges wasn’t connected to the government’s antitrust lawsuit against its proposed merger with Humana.

In marketplace, women may face more coverage gaps than men

Health plans purchased through the marketplace might be disproportionately damaging to women, according to a new study from the National Women’s Law Center. 

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Not everyone says new CMS star ratings deserves 5 stars

Despite CMS efforts to tout its new Medicare star ratings system as a transparency move and a consumer-benefiting action, not everybody is on board yet.

CDC issues warning about swine flu variant

The Centers for Disease Control and Prevention (CDC) are telling children younger than 5, adults over 65 and pregnant women to avoid close contact with pigs at agricultural fairs after four cases of swine influenza infecting people were confirmed in Michigan and Ohio.

Aetna leaving many ACA exchanges, reversing earlier plans

Aetna will exit 11 of the 15 state marketplaces where it currently offers coverage on the Affordable Care Act, citing the same “continued financial stress” as other large insurers that are scaling back exchange business in 2017.

Analysis: Insurers asking for 24 percent hike in premiums on ACA-compliant plans

Insurance companies offering coverage on the individual market have requested a 24 percent average increase in premiums for 2017, according to a new analysis.

ACA rate reviews being used by insurers in unforeseen way

The rate review mechanism enacted by the Affordable Care Act was intended to shame health insurers that asked for large premium hikes, but as the New York Times reports, insurers are trying to use it to their advantage for 2017.

Pathway Health to get a tech upgrade through Virtual Health partnership

Pathway Health, a post-acute consulting firm, and Virtual Health, a population health management technology provider, have entered into a partnership that will provide Pathway with strategic consulting services to improve technology and payment models.

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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