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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US healthcare spending grew 4.6% in 2018

National healthcare expenditures rose 4.6% in 2018, according to new figures from the CMS Office of Actuary.

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ACOs saved $3.5B over 5 years

Accountable care organizations (ACOs) saved Medicare more than $3.53 billion from 2013 to 2017, according to a report from industry group the National Association of ACOs (NAACOS).

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Hospital groups file lawsuit to block price transparency rule

A group of prominent hospital associations have filed a lawsuit against HHS to stop the implementation of a rule that requires hospitals to post their prices for services online and update it regularly.

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Trump may loosen drug patent protections to push trade pact

The pharmaceutical industry could be in for a loss as the Trump administration considers easing patent protection rules in order to garner support from Democrats for a new trade pact between the U.S., Mexico and Canada­––USMCA, The Wall Street Journal reported.

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HHS to make HIV prevention medication free for uninsured

HHS has announced a new initiative to make a medication taken to prevent HIV, pre-exposure prophylaxis, or PrEP, available for free to those without prescription drug insurance coverage.

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CVS enters new deal with Centene

CVS Health is acquiring Centene’s Illinois health plan subsidiary, IlliniCare Health Plan, the companies announced Dec. 2. Financial terms of the transaction were not disclosed.

 

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Global medical costs will rise again in 2020

Medical care costs are set to rise again in 2020, with a projected increased of 6.8%, according to the 2020 Global Medical Trends Survey Report from Willis Towers Watson.

 

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Reconciliation limitations led CMS to overpay hospitals $500M

Hospitals were overpaid by roughly $502 million from 2011 to 2014, according to a report from the Office of Inspector General (OIG), which blamed the overpayment on CMS limitations on the reconciliation period.

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Around the web

Cardiovascular Business
Q&A: MedAxiom CEO explores key trends in cardiologist, cardiovascular surgeon compensation

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

Cardiovascular Business
Payment cuts and beyond: Key takeaways for cardiologists from the 2025 Medicare Physician Fee Schedule

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

AI in Healthcare
A modest proposal to rally AI regulators around a simple game plan

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”