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. 

Analysis: Insurers asking for 24 percent hike in premiums on ACA-compliant plans

Insurance companies offering coverage on the individual market have requested a 24 percent average increase in premiums for 2017, according to a new analysis.

ACA rate reviews being used by insurers in unforeseen way

The rate review mechanism enacted by the Affordable Care Act was intended to shame health insurers that asked for large premium hikes, but as the New York Times reports, insurers are trying to use it to their advantage for 2017.

Pathway Health to get a tech upgrade through Virtual Health partnership

Pathway Health, a post-acute consulting firm, and Virtual Health, a population health management technology provider, have entered into a partnership that will provide Pathway with strategic consulting services to improve technology and payment models.

APA warns psychiatrists against diagnosing public figures from afar

When public figures act or speak differently than usual—or differently than anyone else around them—some people (and the media that cater to them) look for medical or mental-health related explanations. But the American Psychiatric Association (APA) has issued a reminder to its members: Don’t engage in such public analysis diagnostics when you don’t actually know the person in question. 

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State news: Calif. insurer to close for one week; math mistakes cost hospitals in Mass, R.I. millions

Here’s a roundup of the latest state healthcare news, including a deadly bacteria closing down a Maryland neonatal intensive care unit and why one state lawmaker in Missouri has been blocking efforts to create a prescription drug monitoring database.

CMS updates team-based home care program

With enrollment in Programs of All-Inclusive Care for the Elderly (PACE) increasing by 60 percent in the past five years, CMS is proposing changes to “modernize” the team-based home care services program for Medicare and Medicaid beneficiaries.

Hospitals avoiding risky transplants to boost success rates

STAT News reports hospitals are increasingly reluctant to perform transplants involving extremely ill patients or less-than-perfect organs, fearing poor surgical outcomes could lead to reduced hospital ratings and Medicare funding.

ACA risk adjustment may be changed despite improvements in risk pool

In two separate announcements from HHS, the agency said while the risk pool for the health insurance exchanges has improved, it’s “exploring options” to adjust the Affordable Care Act’s risk adjustment program to account for sicker, more expensive enrollees.

Around the web

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. 

These companies were already part of the Johnson & Johnson family, but they had still retained their previous brand names. Now, each one is officially going by Johnson & Johnson MedTech. 

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