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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CVS launches new PBM pricing model

As CVS Health continues to deal with the closure of its $69 billion acquisition of Aetna, its pharmacy benefit manager (PBM) branch is moving ahead with a new pricing model. The new focus could help guarantee net cost predictability and simplify pricing.

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CVS-Aetna deal faces hurdle as WellCare buys out Part D biz

CVS Health has closed its $69 billion acquisition of health insurer Aetna after the deal was approved by all necessary regulators, but the transaction has hit a snag after a judge requested more information from the Department of Justice.

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Trump administration details state of healthcare competition

In the midst of a major consolidation period in the healthcare industry, a new report from the Trump administration sheds light on the current state of competition in the space.

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CNBC: Judge mulls not approving CVS-Aetna agreement

While the $69 billion merger between CVS Health and Aetna has been approved by regulators and cleared by the Department of Justice, a federal judge has raised the prospect of not approving the deal, CNBC reported.

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CMS expands state waiver rules for account-based approach

States will have more flexibility to introduce new healthcare options to residents under a new policy from CMS that impacts waivers.

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AMA: Healthcare insurance markets are highly consolidated, reducing competition

The healthcare industry is in a period of rapid consolidation, with major mergers and acquisitions happening year to year. This consolidation is leading to high concentration levels in 73 percent of health insurance markets, according to a recent study from the American Medical Association.

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CVS Health completes $69B merger with Aetna

The ongoing merger between CVS Health and Aetna officially closed Nov. 28, the companies announced. The $69 billion deal brings together one of the nation’s largest health insurers and retail pharmacy chains and pharmacy benefit managers.

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Cigna-Express Scripts merger delayed

The completion of the $67 billion merger between health insurer Cigna and Express Scripts has been delayed, according to a public filing. The deal was anticipated to close by December 8, but the companies have decided to delay that deadline by six months.

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.”