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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‘Right-to-try’ legislation approved by Congress

The House approved legislation to allow terminally ill the “right to try” experimental drugs not yet approved by the FDA on a largely partisan vote, sending the bill to a supportive President Donald Trump.

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HCA eyeing purchase of Envision with private equity partner

Reuters reports HCA’s proposal would essentially reverse Envision’s 2016 merger with AmSurg. The rest of the $5.1 billion Envision would be taken over by KKR.

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UnitedHealth: Medicaid more cost-effective than ACA plans

UnitedHealth said it costs an average of $9,400 annually to cover a low-income, subsidized enrollee on the marketplace with $7,000 of that cost falling on the federal government. For someone eligible for Medicaid thanks to the Affordable Care Act (ACA), the overall cost is $5,400—with $5,100 coming from federal funds.

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HHS proposing stripping Title X funding from clinics providing, referring abortions

Direct federal funding for abortions has been prohibited by Congress for decades, but conservative lawmakers have sought to deny all federal funding to groups like Planned Parenthood for having any involvement in abortion services.

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Medicare Part D consolidation will only get worse with proposed megamergers

Three sponsors of Medicare Part D plans—UnitedHealth Group, Humana and CVS Health—account for more than half the program’s total enrollment. If proposed mergers involving smaller players like Aetna, Express Scripts and Cigna move ahead, the market would become even more concentrated.

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Vermont’s drug importation plan meets opposition from HHS, PhRMA

Vermont has become the first state to pass a law to allow prescription drugs to be imported from Canada, but the plan still has to be approved by HHS—a tall order considering HHS Secretary Alex Azar’s comments that pharmaceutical imports are a “gimmick” and may be unsafe.

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Primary care compensation rising as practices get spooked about physician shortage

Primary care physicians and non-physician practitioners have seen their compensation rise more rapidly than specialists, which the Medical Group Management Association (MGMA) said is evidence of the worsening shortage of primary care doctors.

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PhRMA opposed to parts of Trump’s drug pricing plan

Lori Reilly, executive vice president of the Pharmaceutical Research and Manufacturers of America (PhRMA), spoke at a panel hosted by the Alliance for Health Policy on May 15, saying the group had “serious concerns” with the plan.

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.”