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 social spending on pace with other countries

U.S. healthcare spending far outpaces other high-income countries, but social spending is not far off, just slightly below average, according to a new study published in Health Affairs.

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CMS to add star ratings to health plans

CMS is planning to add a star ratings system to insurance plans offered through the individual exchange created from the Affordable Care Act, the agency announced August 15. The new ratings will be displayed for the 2020 open enrollment period on Healthcare.gov.

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Changing up CMS model codes improves payment outcomes

A recent study published in JAMA Open Network found that using individual codes and present on admission designations instead of group codes can improve the predictability of patient total payment within 30 days of a hospitalization.

 

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Healthcare among top 10 fastest-growing companies

Two healthcare companies have made Inc.’s top 10 fastest-growing privately held companies in the U.S.

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Employers clamp down on rising healthcare benefit costs

Healthcare benefit costs in the U.S. are expected to rise 5% next year, causing large employers to up their efforts to save, according to a survey from the National Business Group on Health.

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Tufts, Harvard health plans to merge

Two institutional-based health plans in New England have announced their plans to merge.

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PBMs passed on 99% of rebates

Pharmacy benefit managers (PBMs) are only keeping less than 1% of rebates in the Medicare Part D program, passing on the rest of drug savings to plan sponsors, a report from the Government Accountability Office (GAO) found.

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How Vox analyzed and explained the high prices in emergency departments

When Sarah Kliff, healthcare reporter for Vox, saw an emergency department bill charging more than $600 for an encounter that ended with a band-aid, she and the media company undertook a year-long project to explore as many ED bills as possible.

Around the web

The FTC alleges that pharmacy benefit managers have set up a system where they get rich, while patients are forced to pay rising insulin costs. The agency also called out drug manufacturers such as Eli Lilly, Sanofi and Novo Nordisk, saying their own actions have raised serious concerns.

In the post-COVID era, wages for permanent RNs are rising, and wages for travelers are decreasing. A new report tracked these trends and more. 

Two medical device companies have announced a transaction that could shake up the U.S. electrophysiology market. 

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