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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Cigna, Tenet reach agreement on brink of network coverage lapse

Cigna and Tenet announced “good news” on Jan. 1 after reaching an agreement on a new commercial contract. The previous contract between Cigna and Tenet was scheduled to end on New Year's Day, after both companies struggled to come to a new agreement over nearly a year of negotiations.

New transparency rule requiring hospitals to post prices confuses patients

A new federal policy took effect on Jan. 1 that requires hospitals to post standard prices online. However, the rule, which intends to boost transparency, may be causing more confusion than clarity for patients, according to reports.

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Healthcare employment soared through end of 2018

The healthcare industry took the lead as the largest employer in the United States in 2018, with high rates of job growth continuing through the end of the year, according to recent data from the Bureau of Labor Statistics.

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WSJ: Private insurers kept $9B in cash from Medicare

Health insurers have been inflating cost estimates for providing prescription-drug benefits to more than 40 million Medicare beneficiaries, allowing them to cash in $9.1 billion in extra payments from 2006 to 2015, according to a report from The Wall Street Journal.

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Payment cuts to 340B drug program put on pause

A federal judge has intervened in the planned payment cuts to the 340B drug pricing program that enables outpatient facilities to purchase certain drugs at a lower cost.

Obamacare lawsuit appeals process to launch

Several Democratic states have filed notice to appeal the recent court ruling that declared the Affordable Care Act unconstitutional, The Hill reported.

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Judge: ACA to stay in place during appeals process

The Affordable Care Act will remain in place after a judge declared the healthcare rule was unconstitutional in late December. The judge, U.S. District Court Judge Reed O'Connor, has since stated the ACA will remain in effect while the case goes through an appeals process.

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CMS finalizes changes to the ACO program

CMS has finalized changes to the Medicare Shared Savings Program (MSSP) that “dramatically redesigns and sets a new direction” for Medicare accountable care organizations (ACOs). The final rule, as outlined in the proposed rule announced in August, will force ACOs to take on more risk at a quicker pace.

Around the web

If passed, this bill would help clinician-led clinical registries explore Medicare data for research purposes. The Society of Thoracic Surgeons and American College of Cardiology both shared public support for the bipartisan legislation. 

Cardiologists and other physicians may soon need to provide much more information when ordering remote patient monitoring for Medicare patients.

Why are so many cardiovascular devices involved in Class I recalls? One possible reason could be the large number of devices hitting the market without undergoing much premarket clinical testing. 

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