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.

FTC sues PBMs and GPOs for insulin price collusion
In a statement announcing its lawsuit, the FTC said Caremark, Optum RX and Express Scripts benefit from manufacturer rebates and ignore lower-costing drugs as a way to artificially increase prices.
FTC sues drug middlemen over insulin prices, puts others on notice
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.
Study ranks US health system dead last among wealthy nations
Low rankings for accessibility and outcomes earned the country the overall lowest ranking in an analysis of healthcare systems across 10 nations.
Landmark opioid trial in Baltimore set to begin; Johnson & Johnson settles to avoid jury
Six companies have settled with the city for as total of over $402M. Two remaining defendants, McKesson and AmerisourceBergen, will test their luck in court.
Coalition of 86 healthcare groups calls for change to Affordable Care Act rule
In a letter to Congress, the groups are urging lawmakers to support HR 9001 and lift the ban on physician-run hospitals.

CVS CEO: 'We're going to deliver' on what Amazon-JPMorgan-Berkshire deal aspires to do

CVS Health president and CEO Larry Merlo downplayed the threat to its pending $69 billion acquisition of Aetna from the recently announced healthcare partnership between Amazon, JPMorgan Chase and Berkshire Hathaway, saying “what that group aspires to is what we're going to deliver.”

February 9, 2018

Budget deal delays DSH cuts, repeals ACA panel, changes MIPS cost component

The second federal government shutdown of 2018 lasted only six hours, but the budget deal that ended it will have an impact on the healthcare industry for years to come through changes to Medicare payments, the Merit-based Incentive Payment System (MIPS) and repealing one of the most controversial parts of the Affordable Care Act (ACA).

February 9, 2018

Humana will consolidate primary care clinics into new company

During the company’s fourth-quarter earnings call, Humana CEO Bruce Broussard said several subsidiaries running primary care clinic will be merged into one as the insurer becomes more involved in clinical care.

February 8, 2018

Newly renamed Atrium Health to merge with Georgia’s Navicent

Just one day after announcing a name change from Carolinas HealthCare System, Charlotte, North Carolina-based Atrium Health has signed a letter of intent to merge with another system, Navicent Health, based in Macon, Georgia.

February 8, 2018

What is—and isn’t—an Advanced APM in 2018

CMS has outlined which alternative payment models (APMs) qualify as Advanced APM under the Quality Payment Program (QPP) this year, thus giving participating providers a 5 percent payment bonus.

February 7, 2018

Georgia continues as a M&A hotspot with 4 combinations completed or near finished

2018 hasn’t seen a slowdown in mergers and acquisitions among hospitals and health systems in Georgia, with four major combinations now pending or recently completed across the state.

February 7, 2018

5 things healthcare should know about House spending bill

The legislation to keep the federal government running past Thursday, Feb. 8, includes many provisions related to healthcare, including adjustments to the Merit-based Incentive Payment System (MIPS) and delaying Medicare cuts to hospitals while cutting billions from the Affordable Care Act’s Prevention and Public Health Fund.

February 7, 2018

How successes, failures of early CMMI models can inform a 'new direction'

While not all models developed and tested through the Center for Medicare and Medicaid Innovation (CMMI) were successful, each provided valuable lessons for future experiments in care delivery and payment from both government and private payers, according to an article published by Health Affairs.

February 6, 2018

Around the web

Cardiovascular Business

FTC sues drug middlemen over insulin prices, puts others on notice

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.

Cardiovascular Business

Cath lab techs and nurses see new normal with post-COVID pay

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.

Cardiovascular Business

Merit Medical to purchase Cook Medical’s lead management portfolio for $210M

Two medical device companies have announced a transaction that could shake up the U.S. electrophysiology market.