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. 

2015 inpatient PPS rates rule also expands price transparency

The Centers for Medicare and Medicaid Services has issued its hospital inpatient prospective payment system (PPS) and long-term care hospital PPS proposed rule for fiscal year 2015, and included in the rule is a requirement that hospitals begin publically posting what they charge for services by October 1.

CMS sets Oct. 1, 2015 as ICD-10 compliance date

After one month of uncertainty, the Centers for Medicare & Medicaid Services formally announced the new ICD-10 compliance date: Oct. 1, 2015.

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Five Themes to Remember from HIMSS14

Federal mandates, mobile health, patient engagement, privacy and security were top issues.

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Florida legislature may double number of PAs physicians can supervise

The Florida House of Representatives has passed by a margin of 100 to 19 a bill to increase the number of physician assistants (PAs) a single physician may supervise from four to eight. The Florida Senate will consider the bill next.

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Rep. McDermott pushes FTC for more guidance on health system mergers

Rep. Jim McDermott (D-Wash.) has asked the Federal Trade Commission to do more to clarify how it will approach enforcement of the Clayton Act on hospital and health system mergers when many of the provisions in the Affordable Care Act encourage healthcare consolidation.

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OIG recommends lowering Medicare rates for low-risk outpatient surgeries, CMS balks

Noting that the government could save as much as $15 billion, the Office of Inspector General (OIG) has urged the Centers for Medicare and Medicaid Services (CMS) to equalize payment rates for low-risk surgeries performed in hospital outpatient settings with those done at ambulatory surgery centers (ASCs), but so far CMS is not enthusiastic about the idea.

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AHIMA to HHS: Clarify ICD-10 start date

Language in the last minute SGR patch, Protecting Access to Medicare Act of 2014, mandated that ICD-10 be delayed for at least a year but did not specify an exact timeline.

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AHA and hospitals challenge two-midnight rule in federal court

The American Hospital Association, four state hospital associations and four hospital/healthcare systems are taking the Centers for Medicare & Medicaid Services to court over its controversial two-midnight rule that restricts inpatient payment to only be appropriate in cases where the admitting physician expects that the patient will stay in the hospital long enough to cover at least two midnights.

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.