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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Death rates by opioid overdose tied to regional disparities in treatment capacity

Too often in the national opioid epidemic, the resources have seemed ample where the need is slim—and vice versa. The hunch has been confirmed by a study conducted at the University of Texas Health Science Center in Houston and published in the Journal of Addiction Medicine.

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Medicaid expansion linked to lower cardiovascular mortality rates

Amid a national debate over whether or not to dissolve the Affordable Care Act entirely or keep parts of the law intact, research presented at the American Heart Association’s QCOR Scientific Sessions on April 5 suggests Medicaid expansion contributed to a significant decline in cardiovascular-related deaths in recent years.

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New Cigna plan caps monthly out-of-pocket insulin costs at $25

Cigna and Express Scripts announced April 3 they’re launching a Patient Assurance Program that will ensure individuals with diabetes pay no more than $25 out-of-pocket for insulin each month.

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There’s a better way to score hospitals with 1 to 5 stars, researchers say

The creators of CMS’s Overall Hospital Quality Star Rating ratings system—aka “Hospital Compare”—intended to present healthcare consumers with an easy, user-friendly way to choose a hospital. However, since the ratings went live in 2016, the system has proven both confusing to consumers and confounding to hospitals.

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Federal judge rejects expansion of association health plans

A federal judge rejected the Trump administration’s efforts to expand access to association health plans March 29, throwing small businesses that rely on those plans into a state of uncertainty, the Washington Post reported.

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Female Ob/Gyns paid $67K less than male colleagues

Women physicians who work in reproductive health for women earn an average $67,000 less per year than men working in the same field. The pay gap cuts across subspecialties within it, such as reproductive endocrinology, and it holds even after adjusting for years of experience, hours worked and other variables.

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1 in 7 patients receive surprise medical bills

Roughly 1 in 7 patients—or 14.5 percent of hospital admissions in the U.S.—experience surprise medical billing despite seeking care at an in-network facility, according to an analysis by the Health Care Cost Institute (HCCI).

Medicare FFS amassed $23.2B in improper payments in 2017

Medicare fee-for-service (FFS) programs racked up an estimated $23.2 billion in improper payments in 2017, according to CMS data—almost $19 billion more than Medicaid FFS’ $4.3 billion and a red flag that the program’s documentation requirements might not be up to par.

Around the web

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.

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. 

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.”