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. 

Indiana becomes 2nd state approved for Medicaid work requirements

Work requirements have been added to Indiana’s Medicaid program, making it the second state to mandate participation in “community engagement” activities since CMS issued guidelines to states on including those provisions in Section 1115 Medicaid waivers.

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ACA repeal not on Republican agenda for 2018

The priorities for Republicans in Congress this year don’t appear to include another attempt at repealing and replacing the Affordable Care Act (ACA), though some are publicly urging the party to take another shot after several failed attempts in 2017.

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Justice Department requests more info on CVS-Aetna merger

The $69 billion proposed acquisition of Aetna by CVS Health remains under review by the Department of Justice (DOJ), which requested the companies provide more information on their merger agreement.

How Idaho’s insurance plan would violate ACA

The Idaho Department of Insurance has announced it will allow insurers to sell plans which don’t comply with regulations established by the Affordable Care Act (ACA), which could mean the return of plans that deny coverage based on pre-existing conditions, charge higher premiums based on health status and place lifetime or annual caps on benefits.

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5 things to know about proposed MA rates, Part D changes for 2019

CMS has released its proposed rule covering rates in Medicare Advantage (MA) and changes to Medicare Part D for 2019, expanding the definition of health-related supplemental benefits and putting limits on opioid prescriptions for beneficiaries.

Hospitals can expect 7.35% increase in drug prices

Between July 1, 2018, and June 30, 2019, health systems should expect pharmaceutical prices to jump up by 7.35 percent, a slightly lower increase than in recent years as fewer products see “exorbitant” price hikes and costs moderate for high-priced hepatitis C drugs.

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Wellmont, MHSA get final OK to merge into Ballad Health

The merger of Wellmont Health System and Mountain States Health Alliance (MSHA) cleared its last hurdle on Jan. 31, as the Tennessee Department of Health issued the Certificate of Public Advantage (COPA) allowing the deal to be completed.

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AMGA to CMS: ‘Synchronize’ Medicare programs to drive value-based care

Assessing value-based care will require streamlining Medicare regulations across its different programs, defining value and measuring for it, according to the American Medical Group Association (AMGA).

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.”