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.

UnitedHealthcare sues hospital staffing firm TeamHealth, alleging $100M in fraudulent claims

The insurance giant alleged that 62% of claims involving the highest-paying ED codes didn't match medical records, according to documents filed Wednesday.

October 28, 2021

DOJ alleges Kaiser Permanente defrauded Medicare of $1 billion

Kaiser maintains it has done nothing wrong and said it plans to "strongly" defend against lawsuits alleging otherwise.

October 27, 2021

FDA hopes new guidance will prove ‘one of the most significant public health nutrition interventions in a generation’

Aimed at food manufacturers, chain restaurants and food service operators, the document offers target sodium levels for some 163 categories of processed, prepared and packaged foods.

October 14, 2021

Telemedicine has improved access to healthcare

Healthcare access has improved thanks to advances and higher adoption of telemedicine.

October 7, 2021

AMA releases 2022 updates to medical coding

The American Medical Association has released its 2022 updates to the Current Procedural Terminology (CPT) code set.

September 7, 2021

Healthcare orgs given extra time to comply with price transparency

The Biden administration has given healthcare organizations extra time to comply with a price transparency rule.

August 30, 2021

$4.1B savings for Medicare thanks to shared savings program

Medicare’s Shared Savings Program (MSSP) saw its best financial performance in 2020, with 513 participating ACOs saving the CMS more than $4 billion gross and almost $2 billion net.

August 26, 2021

More than 2.5M gained health coverage during special open enrollment

A special enrollment period implemented by the Biden administration saw more than 2.5 million people sign up for health insurance.

August 11, 2021

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.