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. 

Insurers warn individual mandate repeal will raise premiums, drive more away from ACA markets

Health insurers expect the repeal of the Affordable Care Act (ACA)’s individual mandate will make the individual insurance market worse, particularly for customers who don’t have employer-sponsored coverage but make too much money to receive subsidies to lower their premiums.

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ACA funding bills would cancel out hikes from repealing individual mandate

The repeal of the Affordable Care Act’s individual mandate has been projected to cause insurance premiums to rise by an average of 10 percent through 2027. Those hikes would be mitigated, however, if Congress funded the ACA’s cost-sharing reduction subsidies and a $10 billion, two-year reinsurance program, according to an analysis from Avalere.

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AHA to MedPAC: Eliminating, changing MIPS would confuse providers

The American Hospital Association (AHA) suggested the Medicare Payment Advisory Commission (MedPAC) pump the brakes on advocating for major changes to Merit-based Incentive Payment System (MIPS), saying any major shifts wouldn’t have “the benefit of data or experience” considering this is the program’s first performance year.

Want to fight ransomware? Set minimum standards, prioritize education

As cyberattack become increasingly common incidents, healthcare professionals must push security to the forefront. In a presentation given at the annual meeting of the Radiological Society of North America (RSNA) in Chicago, Jim Whitfill, CMO of innovation Health Partners and president of Lumetis, described the current cybersecurity environment and detailed how professionals can take steps toward improving privacy.

Paul Ryan not committing to ACA fix

Sen. Susan Collins, R-Maine, based her vote in favor of the Senate Republican tax cut plan on the promise Senate Majority Leader Mitch McConnell, R-Kentucky, would back two bills to help the Affordable Care Act (ACA) exchanges. House Speaker Paul Ryan, R-Wisconsin, however, isn’t making the same commitment, according to The Hill.

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Major insurers’ reliance on Medicaid, Medicare revenues could be used to boost ACA participation

The largest health insurers—UnitedHealthcare, Aetna, Anthem, Cigna and Humana—are getting nearly 60 percent of their total combined revenue from Medicare and Medicaid plans, according to a Health Affairs study, with that money more than doubling since the Affordable Care Act (ACA) was passed.

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CMS finalizes cancellation of mandatory bundles

In a final rule issued on Nov. 30, CMS finalized changes to several mandatory bundled payment programs, canceling two surrounding hip fractures and cardiac care and reducing requirements in a joint replacement bundle.

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CBO: Funding CSRs won’t mitigate impact from repealing individual mandate

The Congressional Budget Office (CBO) said passing an Affordable Care Act (ACA) stabilization measure after getting rid of the ACA’s individual mandate would still leave 13 million fewer people insured by 2027 and cause premiums increase by an average of 10 percent over the same time period.

Around the web

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.

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. 

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

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