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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Healthcare price growth hits 6-year high

Prices across the healthcare sector rose 2.2 percent year-over-year in March 2018, the highest annual growth rate recorded by Altarum since January 2012, with the report warning rapid price growth is likely to continue.

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Chicago’s Rush calls off merger with suburban hospital

The Rush hospital system based in Chicago has ended plans to acquire Little Company of Mary of Evergreen Park, Illinois, which would’ve merged 12 facilities with Rush University Medical Center and its 2,500-student health sciences college.

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Drug competition didn’t stop sharp increase in MS spending

The report from the Health Care Cost Institute (HCCI) examined claims for people with multiple sclerosis (MS) from 2009 to 2015 covered by individual market, employer-sponsored or Medicare Advantage plans. It found total spending per MS patient rose from around $23,900 to $39,628 by 2015. During the same time period, the share of spending spent towards injectable and oral disease modifying therapies (DMTs) rose from 39 percent to 53 percent.

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5 things to know about the final ACA rule for 2019

In a final rule that CMS said would help customers “suffering from high Obamacare premiums,” the agency’s 2019 rule for the Affordable Care Act (ACA) exchanges would give states more power on how plans cover required benefits and widen exemptions to the law’s individual mandate in the final year customers can be penalized for not having ACA-compliant insurance.

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Insurance leaders warn big ACA premium hikes coming for 2019

Insurance companies are beginning to decide what they’ll charge and whether to participate on the Affordable Care Act (ACA) exchanges for 2019, with Matt Eyles, the next CEO of America’s Health Insurance Plans (AHIP), saying it’s “not a pretty picture right now” for individual market insurers.

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It’s Optum, not Amazon, that is ‘scaring the crap' out of hospitals

For all the attention given to forays from Amazon, Apple and Walmart into the healthcare space, traditional providers are more worried about the continued expansion of UnitedHealthGroup’s Optum into clinical care, according to an article in Bloomberg.

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California would control healthcare prices for privately insured under new legislation

A new bill introduced in California’s state legislature would put the state in charge of setting rates for medical services covered by private insurers, setting up a battle between consumer groups and the lobbyists for the healthcare industry.

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$2.6B collected from healthcare fraud cases by HHS, DOJ

In fiscal year 2017, HHS and the U.S. Department of Justice (DOJ) recovered nearly $2.6 billion from settlements and judgments in healthcare fraud cases, with $1.4 billion being transferred to the Medicare Trust Funds.

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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