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.

CMS to cancel mandatory bundles

A rule title posted to the Federal Register on Aug. 10 indicates CMS will cancel two mandatory bundled payment programs, the Advancing Care Coordination through Episode Payment Models (EPMs) and Cardiac Rehabilitation Incentive (CRI) Payment Models, while changing a separate payment program on joint replacements.

August 14, 2017

Trump to declare ‘national emergency’ on opioid crisis

Following up on recommendations by his own White House commission, President Donald Trump said he will declare a national public health emergency on the opioid addiction epidemic, which would have an impact on healthcare providers.

August 11, 2017

ACA insurers seeking premium hikes as high as 49% due to policy uncertainty

In an analysis of what Affordable Care Act (ACA) exchange insurers are requesting to charge customers in 21 major cities in 2018, the Kaiser Family Foundation found the cost for the second-lowest silver-level plan will range from $244 to $631 per month, with most enrollees cushioned from the price hikes by federal subsidies.

August 10, 2017

Bringing Medicare into ACA markets could boost competition

With nearly 40 percent of counties nationwide being at risk of having no insurer on their Affordable Care Act (ACA) exchange next year, a lack of competition for marketplace customers is a concern.

August 10, 2017

Part 2, Q&A with next HIMSS CEO Hal Wolf: Health IT industry shouldn’t fear AI

Embracing artificial intelligence (AI) technology is “a necessity” for the health IT industry, according to Harold “Hal” Wolf III, the next president and CEO of the Healthcare Information and Management Systems Society (HIMSS).

August 8, 2017

HITECH Act increases adoption of EHRs in hospitals

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was introduced to increase the rate of integration of electronic health records (EHRs). In a recent study, published by Health Affairs, researchers analyze if the bill was able to increase EHR adoption.

August 7, 2017

It may be too late to stabilize ACA markets for 2018

The stalling of Republican efforts to repeal and/or replace the Affordable Care Act has led to renewed talks of short-term measures to keep premiums down and keep insurers from leaving ACA exchanges, but those measures may be coming too late.

August 7, 2017

Senate passes ‘right-to-try’ bill which critics call ‘deceptive’ to terminal patients

The U.S. Senate unanimously passed a bill on Aug. 3 which would allow terminally ill patients the “right to try” experimental treatments that haven’t yet been approved by the Food and Drug Administration (FDA), but critics say it gives patients false hope without allowing for federal oversight.

August 4, 2017

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.