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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Cigna, Tenet reach agreement on brink of network coverage lapse

Cigna and Tenet announced “good news” on Jan. 1 after reaching an agreement on a new commercial contract. The previous contract between Cigna and Tenet was scheduled to end on New Year's Day, after both companies struggled to come to a new agreement over nearly a year of negotiations.

New transparency rule requiring hospitals to post prices confuses patients

A new federal policy took effect on Jan. 1 that requires hospitals to post standard prices online. However, the rule, which intends to boost transparency, may be causing more confusion than clarity for patients, according to reports.

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Healthcare employment soared through end of 2018

The healthcare industry took the lead as the largest employer in the United States in 2018, with high rates of job growth continuing through the end of the year, according to recent data from the Bureau of Labor Statistics.

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WSJ: Private insurers kept $9B in cash from Medicare

Health insurers have been inflating cost estimates for providing prescription-drug benefits to more than 40 million Medicare beneficiaries, allowing them to cash in $9.1 billion in extra payments from 2006 to 2015, according to a report from The Wall Street Journal.

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Payment cuts to 340B drug program put on pause

A federal judge has intervened in the planned payment cuts to the 340B drug pricing program that enables outpatient facilities to purchase certain drugs at a lower cost.

Obamacare lawsuit appeals process to launch

Several Democratic states have filed notice to appeal the recent court ruling that declared the Affordable Care Act unconstitutional, The Hill reported.

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Judge: ACA to stay in place during appeals process

The Affordable Care Act will remain in place after a judge declared the healthcare rule was unconstitutional in late December. The judge, U.S. District Court Judge Reed O'Connor, has since stated the ACA will remain in effect while the case goes through an appeals process.

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CMS finalizes changes to the ACO program

CMS has finalized changes to the Medicare Shared Savings Program (MSSP) that “dramatically redesigns and sets a new direction” for Medicare accountable care organizations (ACOs). The final rule, as outlined in the proposed rule announced in August, will force ACOs to take on more risk at a quicker pace.

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.”