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.

Hospital sues insurer over use of AI to deny $2M in claims
AdventHealth Shawnee Mission is suing Blue Cross and Blue Shield of Kansas City over its AI claims audits, which have rejected some 350 incidents of patient care. The hospital claims the insurer is violating state and federal laws.
FDA issues recall on defective cranial drills after 10 injuries
The devices are manufactured by Integra LifeSciences. Due to a manufacturing error where inadequate welding has caused bits to get stuck in patients’ skulls, this recall has been designated as the most serious type.
GOP senator introduces bill to repeal federal Medicaid cuts
Josh Hawley (R-MO) voted for the “One Big, Beautiful Bill Act,” which narrowly passed the Senate. Now he’s introducing legislation to increase funding for rural hospitals and roll back cuts to safety-net healthcare programs.
HHS formally lays off thousands of employees following SCOTUS ruling
After the Supreme Court lifted a lower court injunction, approximately 10,000 employees at the U.S. Department of Health and Human Services were officially terminated.
ASNC lobbies Congress to curb prior authorization, oppose AUC mandates and embrace payment reform
Suman Tandon, MD, an American Society of Nuclear Cardiology board member, explains the group's call on Congress to update a number of healthcare policies.

Another 89 ACOs join federal cost-sharing programs

Eighty-nine new accountable care organizations (ACOs) serving 1.2 million Medicare patients in 40 states and Washington, D.C. officially entered into agreements with the Centers for Medicare & Medicaid Services (CMS) as of July 1.

Cleveland system keeps up with computer-assisted coding, documentation improvement

The Cleveland Clinic Health System (CCHS) is successfully evolving, using computer-assisted coding (CAC) to address clinical documentation improvement, ICD-10 implementation and more, according to an article published in the July issue of Journal of AHIMA.

Geisinger, Merck collaborate for patient adherence

Geisinger Health System and pharmaceutical company Merck will enter into a new multi-year collaboration designed to improve patient health outcomes by focusing on shared decision making between patients and physicians and improved patient adherence.

NEJM: Release your inner health IT productivity

A perspective article published in the June 14 edition of the New England Journal of Medicine set out to explain the IT productivity paradox and its relation to the rise of health IT implementations.

PwC: Healthcare spending growth slow for 4th year

Growth in healthcare spending in the U.S. has slowed considerably since 2009, according to PricewaterhouseCoopers's Health Research Institute. The organization projects medical costs will increase 7.5 percent for 2013, the fourth year in a row of relatively flat growth.

South Shore Hospital's security mistake results in $750K settlement

South Shore Hospital in Boston has agreed to pay $750,000 to resolve allegations because the provider failed to protect the personal and confidential health information of more than 800,000 consumers, Massachusetts Attorney General Martha Coakley announced. The investigation and settlement resulted from a data breach reported to the AGs office in July 2010 that included individuals names, Social Security numbers, financial account numbers and medical diagnoses.

Milliman offers ACO cheat sheet

Actuarial firm Milliman has released an accountable care organization (ACO) cheat sheet to guide stakeholders through the ins and outs of Medicare Shared Savings Program and the Pioneer ACOs.

Health Affairs: EHR adoption programs should look beyond PCPs

To achieve EHR adoption nationwide, federal policies also may have to focus on encouraging adoption among non-primary care specialists, as well as addressing persistent gaps in the use of EHR systems by practice size, physician age and ownership status, according to an article published in the April edition of Health Affairs.

Around the web

Cardiovascular Business

ASNC lobbies Congress to curb prior authorization, oppose AUC mandates and embrace payment reform

Suman Tandon, MD, an American Society of Nuclear Cardiology board member, explains the group's call on Congress to update a number of healthcare policies.

Cardiovascular Business

CMS proposal includes cardiologist pay bump—cuts to high-value services still a concern

The 2026 MPFS proposed rule includes higher conversion factors across the board. However, some cardiology groups remain concerned about a series of reimbursement reductions for high-value cardiology services.

Cardiovascular Business

With MPFS proposal on the way, electrophysiology groups outline their priorities

The Heart Rhythm Society and its new advocacy arm plan on pushing CMS to include certain policy improvements in the 2026 MPFS.