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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Prior authorization under fire in Inspector General investigation

An investigation from the Office of the Inspector General (OIG) regarding prior authorization requirements in Medicare Advantage (MA) plans revealed concerns about access to care.

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More than 400 nursing homes expected to close this year

The 400+ closures projected for 2022 are nearly double the next highest year, when 220 nursing homes closed in 2019.

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Pfizer recalls hypertension drug over cancer risk

Drug maker Pfizer has voluntarily recalled a hypertension drug due to the presence of a potentially cancer-causing nitrosamine.

VIDEO: The importance of the Physician Practice Information Survey and its impact on radiology reimbursements

Linda Wilgus, CPA, CMPE, executive director and chief financial officer of Northwest Radiology Network and a past president of the Radiology Business Management Association (RBMA), explains the importance of the Physician Practice Information Survey CMS in calculating radiology reimbursements.

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Hospitals, health systems still grappling with price transparency rules

Hospitals and health systems have been forced to post their prices for some 300 services since the start of 2021 thanks to a recent price transparency rule.

 

Biden administration fights mask mandate repeal

The Biden administration will fight back and appeal a ruling that overturned the federal mask mandate on airlines and public transportation.

 

Politico: Biden to toss Trump’s ‘conscience’ rule for healthcare workers

The Biden administration is making a move to get rid of a rule that allows healthcare workers to refuse to provide services that go against their personal beliefs. 

The ASNC is one of several medical imaging societies asking Congress to repeal the appropriate use criteria (AUC) criteria mandate. They say it poses issues for clinicians and is becoming outdated by changes in CMS payment systems. The AUC requirements call for documentation using CVMS authorized software in order to show advanced imaging such as nuclear and CT is justified, or else Medicare payments might be withheld.

American Society of Nuclear Cardiology urges Congress to speed prior authorizations, repeal AUC mandate 

Over the past few weeks, members of ASNC’s Health Policy Committee have held meetings with their members of Congress.

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Around the web

Cardiovascular Business
Q&A: MedAxiom CEO explores key trends in cardiologist, cardiovascular surgeon compensation

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.

Cardiovascular Business
Payment cuts and beyond: Key takeaways for cardiologists from the 2025 Medicare Physician Fee Schedule

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. 

AI in Healthcare
A modest proposal to rally AI regulators around a simple game plan

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.”