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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Nursing homes using hospitals as middlemen to bounce low-reimbursement, high-maintenance residents

A common tactic is sending off Medicaid-covered seniors with dementia following emergency “psychotic” episodes. When psychiatric wards and hospitals quickly discharge the patients, the nursing homes refuse to take them back in.

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Rand study suggests hospitals are exorbitantly overpaid by private insurers; AHA reacts

In real dollars, these payers’ combined savings would have nearly reached $20 billion just in 2018, the analysis shows.

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Lawmaker ‘deeply concerned’ over $250M HHS contract for coronavirus-related PR work

Rep. Frank Pallone Jr., D-N.J., worries the agency is using taxpayer funds to fuel the commander-in-chief’s bid for a second term. 

Alleged Stark violations, kickbacks to cost hospital $50M

A 223-bed acute care institution with a medical staff of nearly 300 physicians has agreed to pay $50 million over allegations it deliberately submitted ineligible claims to Medicare and profited handsomely by these actions.  

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4 hurdles thwarting AI from conquering clinical practice

AI will not earn a place in the daily practice of medicine until its developers definitively answer some pressing questions on fitness and appropriateness.

Researchers clarify: Don’t dismiss the neck gaiter as a facemask failure

Remember the Duke study that seemed to suggest a neck gaiter can spread more COVID than no mask at all? Its authors now say their findings were misconstrued. Gaiters may be OK after all.

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Standard operating procedures start chugging back to life at Medicare, Medicaid

As part of its Monday announcement, CMS released inspection guidance for state agencies and a toolkit for nursing homes.

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$66M to hospitalize 38 patients over 3 weeks—would you take that deal?

Responding swiftly to the COVID crisis this past spring, the city of Chicago imagined, built and began operating a nicely outfitted, high-capacity hospital in just three weeks and five days. That was the impressive part.

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.