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.

FDA announces recall of Pfizer's fast-tracked sickle cell drug
The drugmaker is voluntarily withdrawing Oxbryta from the market due to a higher-than-acceptable risk of death.
Public health coalition wins lawsuit against EPA for lack of fluoride oversight
A federal judge in California ruled existing evidence of the negative effects of fluoride in drinking water warrants an investigation and potential action from the Environmental Protection Agency.
Cardiology groups cheer new bill that would improve access to Medicare claims data
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.
Walmart workers sue over tobacco fees levied for health plan trust
The class action lawsuit argues employees cannot escape the fees even after they stop using tobacco, a violation of labor regulations.
HHS awards $75M for addiction and maternal health services in rural areas
The funds will be used to expand services and improve the financial stability of existing healthcare organizations located in underserved regions of the South.

Kentucky becomes 1st state approved for Medicaid work requirements

Days after CMS first issued policy guidance on how states could require “able-bodied” Medicaid beneficiaries to work or face losing their coverage, Kentucky has become the first with an approved waiver to test out those requirements.

January 12, 2018

More ACOs taking on downside risk in MSSP in 2018

The Medicare Shared Savings Program (MSSP) will have 561 accountable care organizations (ACOs) participating in 2018, including 124 new entrants into the program, covering a total of 10.5 million assigned beneficiaries, according to CMS.

January 12, 2018

MGMA: CMS late again on notifying clinicians of MIPS eligibility

Full-year quality reporting will be required in the Merit-based Incentive Payment System (MIPS) for the first time in 2018, but clinicians haven’t received word from CMS on whether they’re eligible to participate, according to the Medical Group Management Association (MGMA).

January 12, 2018

MedPAC votes to recommend repealing MIPS

Following up on criticisms of the Merit-based Incentive Payment System (MIPS) at recent meetings, the Medicare Payment Advisory Commission (MedPAC) formally voted to recommend scrapping the payment system, arguing the program replicates flaws from those it was meant to replace.

January 11, 2018

CMS push for Medicaid work requirements likely to be challenged in court

CMS has released guidance for how states can seek Medicaid waivers imposing requirements for beneficiaries to work in order to receive coverage, a move which some healthcare groups quickly condemned and threatened to sue in order to stop.

January 11, 2018

How the Trump administration planned to change the ACA

A never-before-released document shows the extent of plans within HHS and the Trump administration to alter the Affordable Care Act (ACA) through executive and regulatory action, many of which have since been enacted.

January 11, 2018

Humana leaves AHIP

Humana has terminated its membership in America’s Health Insurance Plans (AHIP), the largest lobbying group for the health insurance industry, following the departures of other major insurers in recent years. 

January 11, 2018

CDC recommends using ‘Obamacare’ over ‘ACA’

Brenda Fitzgerald, MD, director of the Centers for Disease Control and Prevention (CDC), again denied the agency has banned words such as “fetus,” “science-based” and “transgender” from official documents in a letter to Sen. Brian Schatz, D-Hawaii, but did reveal the style guide used by HHS recommends avoiding certain words and substituting others.

January 10, 2018

Around the web

Cardiovascular Business

Cardiology groups cheer new bill that would improve access to Medicare claims data

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.

Cardiovascular Business

Watchdog group, fearful of fraud, wants more oversight for remote patient monitoring

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

Cardiovascular Business

Most recalled cardiovascular devices gained FDA approval with little to no clinical evidence

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.