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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Aetna sued again over claims denial

Aetna’s legal department remains busy. Days after the company settled out of court with a patient who sued for coverage denial in California, it’s in the news in Florida for much the same reason—but with a bigger claimant.

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CMS takes steps to beef up oversight of accrediting organizations

CMS has proposed a new rule that aims to improve transparency around accrediting organizations (AOs) that certify healthcare facilities in the Medicare program. Specifically, the rule creates a new process for AOs to follow if there is a sale, transfer or purchase of assets in the ownership of the organization.

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10 best and worst states for nurses

Not all states are equal when it comes to the job quality and opportunity of being a nurse the U.S. While the profession is in high demand, with expectations that the industry will double the rate of the average occupation by 2026, there are several challenges to being a nurse depending on location.

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Variations in healthcare prices don’t reflect quality

Within the same metro area, the price of some common health services can vary up to 39-fold, while services can differ 25-fold across areas, according to the latest issue brief from the Health Care Cost Institute (HCCI).

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HHS lowers monetary penalties for HIPAA violations

HHS has changed its regulations for civil monetary penalties (CMP) under the Health Insurance Portability and Accountability Act (HIPAA), effectively lowering penalties across four categories of violations.

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Hospital employment, pay on the rise across the board

Overall U.S. hospital employment hit 5,223,000 in March, rising 2.11% over the 5,115,000 recorded in March of 2018, according to the latest numbers from the Bureau of Labor Statistics.

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Aetna settles with patient who sued for coverage denial

A little over a year ago, California’s insurance commissioner began investigating Aetna for possibly denying care coverage without reviewing the records of a patient who’d filed a lawsuit. Now the company has agreed to an out-of-court settlement.

Voters trust Democrats more than Republicans when it comes to healthcare

Healthcare is a major voter issue, but many Americans tend to trust Democrats more than Republicans in this area heading into the 2020 election, according to a new poll from the Associated Press-NORC Center for Public Affairs Research.

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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