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.

Some reviewers opposed FDA's approval of new drug for life-threatening disease
When the FDA approved elamipretide for the treatment of Barth syndrome, not everyone agreed with the agency's decision.
GLP-1 weight loss drugs will now be covered by Medicare and Medicaid—and available at a discount through TrumpRx
Novo Nordisk and Eli Lilly have agreed to sell their popular Wegovy and Zepbound injectables through TrumpRx.gov for a discounted rate, as the White House promises that Medicaid and Medicare plans will begin covering the costs.
Ohio AG investigating business practices of nonprofit safety net hospital
Authorities said in a court filing that they received a complaint about Northeast Ohio Neighborhood Health Services’ business practices. The health system owes more than $12 million to creditors, and investigators are asking to see its financial records.
California chooses Innovaccer's AI to improve Medicaid outcomes for vulnerable populations
The company will analyze claims data from over 2 million people enrolled in Medi-Cal. The data will be used for compliance reporting and to improve patient care coordination.
Society of Interventional Radiology urges UHC to update policy on radioembolization treatment
SIR contends that payments toward transarterial radioembolization (TARE)/selective internal radiation therapy (SIRT) should extend beyond the current coverage limitations in patients with liver cancer and metastases.

Some reviewers opposed FDA's approval of new drug for life-threatening disease

When the FDA approved elamipretide for the treatment of Barth syndrome, not everyone agreed with the agency's decision.

GLP-1 weight loss drugs will now be covered by Medicare and Medicaid—and available at a discount through TrumpRx

Novo Nordisk and Eli Lilly have agreed to sell their popular Wegovy and Zepbound injectables through TrumpRx.gov for a discounted rate, as the White House promises that Medicaid and Medicare plans will begin covering the costs.

Ohio AG investigating business practices of nonprofit safety net hospital

Authorities said in a court filing that they received a complaint about Northeast Ohio Neighborhood Health Services’ business practices. The health system owes more than $12 million to creditors, and investigators are asking to see its financial records.

California chooses Innovaccer's AI to improve Medicaid outcomes for vulnerable populations

The company will analyze claims data from over 2 million people enrolled in Medi-Cal. The data will be used for compliance reporting and to improve patient care coordination.

prior authorization claim deny denial insurance insurer payer Medicare Advantage

Society of Interventional Radiology urges UHC to update policy on radioembolization treatment

SIR contends that payments toward transarterial radioembolization (TARE)/selective internal radiation therapy (SIRT) should extend beyond the current coverage limitations in patients with liver cancer and metastases.

artificial intelligence AI explainable ethical responsible

Monitoring, reimbursement and transparency—ACR offers White House recs for AI regulation

ACR’s input is included as part of America’s AI Action Plan, which was created to help implement emerging AI technologies into everyday workflows.

Insulin pumps recalled due to malfunction risk—users warned to update software

The new Class I recall covers nearly 18,000 insulin pumps distributed throughout the United States. While this is not a product removal, users are being urged to update their devices immediately.

Large-scale policy changes fail to boost heart failure outcomes—what else is needed?

A system-wide initiative in Sweden helped hospitals reduce readmission rates and shorten lengths of stay. When it came to heart failure patients specifically, however, the changes barely made an impact.