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. 

Final 2015 Medicare Advantage cuts could come Monday

The proposed 2015 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies are scheduled to be finalized on Monday, at which point providers and health plans will find out if they will see another cut to the Medicare Advantage program next year.

Global group releases software as a medical device framework

The International Medical Device Regulators Forum's Software as a Medical Device (SaMD) Working Group, which represents a voluntary group of regulators from 10 countries, has released a proposed framework to harmonize international medical device regulations as they relate to SaMD.

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CMS to release individual Medicare physician payment data

As early as next week, the Centers for Medicare and Medicaid Services plans to release data on what it pays doctors at the individual physician level, a move long opposed by physician groups such as the American Medical Association (AMA).

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States may offer solution to ACA grace period problem

Washington state has passed the first law to require insurers to quickly notify physicians when patients enrolled in exchanges under the Patient Protection and Affordable Care Act (ACA) stop paying their premiums, and other states may follow its lead.

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ICD-10 delay finalized

It probably seemed like an April Fools joke to many in healthcare, but this week another ICD-10 delay means the transition won’t happen until at least Oct. 1, 2015.

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GOP budget proposal has drastic changes and steep cuts for healthcare

The fiscal year 2015 budget the House Budget Committee marks up today would cut about $2.9 trillion in health care spending over 10 years and turn Medicare into a premium support program.

AMA spent millions only to get another SGR fix

Tuesday, President Obama signed H.R. 4302 into law. It is the 17th temporary sustainable growth rate (SGR) formula fix passed by Congress, but the first such fix actually opposed by the American Medical Association (AMA), which had spent millions to try to win a permanent repeal.

As purchaser, CMS seeks more data, higher value return

The Centers for Medicare & Medicaid Services want value out of what they are purchasing, and thus increasingly will expect states to share more data on the care delivery of the 65 million Medicaid beneficiaries nationwide, said Jessica Kahn, MPH, director of the Division of State Systems at CMS at the State Healthcare IT Connect Summit on April 1.

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.