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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Examination of private insurance claims data offers new insights

A recent report examining employer-sponsored private insurance claims data found that basing healthcare decisions on Medicare data might not be the best practice. The researchers found that the correlation between total spending per Medicare beneficiary and total spending per privately insured beneficiary was 0.14 in 2011, while the correlation for inpatient spending was 0.267.

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CMS looks to adapt ACO benchmarks to regional realities

The Centers for Medicare and Medicaid Services is proposing changes in the benchmarks it uses to evaluate ACOs in the Medicare Shared Savings Program.

California hospital pays more than $3.2 million to settle allegations

A hospital in Oceanside, Calif., agreed to pay more than $3.2 million to settle claims it violated laws and Medicare’s prohibition on having an illegal financial relationship with referring physicians.

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Government Accountability Office finds flaws in FDA's methods

According to a new 42-page report published by investigators from the Government Accountability Office (GAO), there are significant flaws in the way the FDA tracks drugs after they come to market. 

Supreme Court won't hear Medtronic case

Caplinger v. Medtronic Inc., the lawsuit in which a patient accused Medtronic of allowing doctors to use its INFUSE Bone Graft product in ways not approved by the FDA, made it all the way to the U.S. Supreme Court, but the Court announced it has declined to hear the case. 

Nonprofit hospitals under the taxman’s magnifying glass

Nonprofit hospitals getting challenged on their tax-exempt status have been much in the news of late.  

Slavitt shares CMS implementation goals for 2016

Successfully achieving change in healthcare is 90 percent about implementation, said Andy Slavitt, acting director of the Centers for Medicare & Medicaid Services, speaking at the 34th Annual J.P. Morgan Healthcare Conference in San Francisco.

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Obama vetoes ACA repeal bill, but Republicans claim a victory of sorts

President Obama has fended off Congressional Republicans’ latest stab at rolling back the Affordable Care Act, but this time GOP legislators says things are different: They succeeded for the first time in getting a repeal bill onto the President’s desk.

Around the web

The tirzepatide shortage that first began in 2022 has been resolved. Drug companies distributing compounded versions of the popular drug now have two to three more months to distribute their remaining supply.

The 24 members of the House Task Force on AI—12 reps from each party—have posted a 253-page report detailing their bipartisan vision for encouraging innovation while minimizing risks. 

Merck sent Hansoh Pharma, a Chinese biopharmaceutical company, an upfront payment of $112 million to license a new investigational GLP-1 receptor agonist. There could be many more payments to come if certain milestones are met.