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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Mississippi gets 1st 10-year Medicaid demonstration waiver

For the first time, CMS has approved a 10-year extension of a Medicaid Section 1115 demonstration waiver allowing the state to provide family planning services to residents with incomes up to 194 percent of the federal poverty level.

Misclassified drugs cost Medicaid $1.3B

Pharmaceutical manufacturers paid $1.3 billion less to Medicaid by receiving rebates on misclassified generic drugs, according to a report from the HHS’s Office of the Inspector General (OIG).

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ACA bills for reinsurance, insurer subsidies won’t be considered this year

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After previously saying she had secured a commitment to pass the legislation by the end of 2017, Sen. Susan Collins, R-Maine, said bills to fund the Affordable Care Act (ACA)'s cost-sharing reduction subsidies and provide $5 billion in reinsurance will be left out of a year-end spending package.

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What happens to the ACA without the individual mandate

The Republican tax cut plan, including a repeal of the Affordable Care Act’s individual mandate, has passed through Congress, giving the party a victory in its yearlong struggle to find consensus on legislation to substantially alter the ACA.

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HHS withholding comments critical of loosening religious exemptions

In October, the Trump administration had asked for public comments on how to reduce HHS regulations on religious and faith-based groups. Of the 12,302 comments received, the agency has only posted 80, which mostly back the administration’s efforts and attack Obama-era policies on abortion and treating transgender patients.

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CMS denies Oklahoma’s request to use Medicaid funds for med school recruitment

The medical schools and teaching hospitals at the University of Oklahoma and Oklahoma State University could require an immediate injection of funds after CMS denied a request by the state to use federal Medicaid funds to pay those schools to recruit, train and retain physicians.

States eye their own coverage requirements if individual mandate is repealed

If Republicans pass their tax cut plan as expected, including a repeal of the Affordable Care Act (ACA)’s individual mandate, Democratic-leaning states may respond with laws requiring their residents to buy health insurance or face a tax penalty.

Lawsuit on ACA insurer subsidies settled

The administration of President Donald Trump has settled a long-running lawsuit over cost-sharing reduction subsidies paid to insurers as part of the Affordable Care Act (ACA), potentially paving the way for the payments to be restored.

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Around the web

Cardiovascular Business
Q&A: MedAxiom CEO explores key trends in cardiologist, cardiovascular surgeon compensation

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.

Cardiovascular Business
Payment cuts and beyond: Key takeaways for cardiologists from the 2025 Medicare Physician Fee Schedule

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. 

AI in Healthcare
A modest proposal to rally AI regulators around a simple game plan

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.”