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. 

Congress focused on mental health, Medicare price negotiations as 2023 approaches

With the midterms in the rearview, the lameduck Congress is focused on a handful of healthcare priorities heading into 2023, including mental health and implementing recent Medicare price negotiations afforded in the Inflation Reduction Act.

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AI-powered platform for heart failure detection gains FDA clearance

According to data submitted to the FDA, the platform has been linked to an accuracy of 90%, sensitivity of 87.8% and specificity of 83%.

VIDEO: Impact of the 2023 Medicare cuts on radiology

Ed Gaines, JD, vice president of regulatory affairs and industry liaison, Zotec Partners, discussed the impact of the 2023 Medicare Fee Schedule on radiology at RSNA 2022 in Chicago last week. RSNA and several other medical societies say the cuts are not sustainable.

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Healthcare groups react to prior authorization proposed rule

Healthcare groups are largely excited by a new proposed rule from the Centers for Medicare and Medicaid Services (CMS) that aims to streamline prior authorization and reduce burden on healthcare providers.

Ed Gaines, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners, discusses the No Surprises Act on radiology at the Radiological Society of North America (RSNA) 2022 meeting. Gaines works with RSNA on billing and Medicare issues and spoke in sessions at the RSNA 2022 meeting. Insurance companies have weaponized the No Surprises Act in an effort to cut their costs, he said.

VIDEO: Insurance companies have weaponized the No Surprises Act, may impact patient care

Ed Gaines, JD, CCP, vice president of regulatory affairs and industry liaison, Zotec Partners, discusses the impact of the No Surprises Act on healthcare and medical imaging at the RSNA 2022 meeting

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CMS proposes rule on prior authorization

Prior authorization, which requires healthcare providers to get approval from insurance providers before giving certain treatments to patients, has been long-hailed as extremely burdensome to physicians, even causing delays in patient care.

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Integra LifeSciences to acquire SIA in deal worth up to $140M

Integra LifeSciences Holding Corporation, a global medical technology company, has agreed to acquire Surgical Innovation Associates (SIA), which is known as the manufacturer of monofilament mesh for plastic and reconstructive surgery. The deal is valued up to $140 million.

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Amazon’s $3.9B acquisition of One Medical under review in Oregon

The state of Oregon is taking a hard look at the proposed acquisition of One Medical by Amazon. The deal is valued at $3.9 billion.

Around the web

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.

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. 

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.”