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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Number of Americans impacted by Change Healthcare breach nears 200M

The last count submitted to HHS in October pegged the number at 100 million. Now that figure sits at 190 million, and the company continues its investigation. 

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CMS drops lawsuit against UnitedHealth over Medicare Advantage star rating

The Centers for Medicare & Medicaid Services appealed a court ruling that ordered the agency to change the star rating for UnitedHealthcare's Medicare Part D plans, which had been reduced due to a disputed phone call. CMS has now dropped the appeal.

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MGMA's perspective on CMS’s 2030 shift to value-based care

Anders Gilberg, Senior Vice of Government Affairs at Medical Group Management Association, explains the issues that will complicate moving Medicare from fee-for-service to value-based care models in five years. 

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Industry Watcher’s Digest

When Larry Ellison talks about healthcare AI, people invest. At least, that’s what happened after the Oracle chairman enthused over AI’s potential to cook up vaccines for cancer. 

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Nat’l Academy of Medicine sets ‘priorities for action’ as healthcare mulls next moves with AI

Given the precarious excitement of the moment—or is it exciting precarity?—policymakers and healthcare leaders must set directives guiding not only what to do with AI but also when to do it. 

MGMA's Anders Gilberg calls on CMS and Congress to extend telemedicine and highlights the issues involved.

Congress hesitates on long-term telemedicine expansion admid advocacy push

Congress temporarily extended telemedicine provisions until March amid lobby efforts by the Medical Group Management Association (MGMA) and others to make the provisions permanent.

Republican Sen. Jeffrey Gordon, MD

State lawmaker wants increased scrutiny around Rad Partners affiliate Jefferson Radiology

Republican Sen. Jeffrey Gordon, MD, said Wednesday that he has heard from a dozen constituents about the issue and also discussed it with his physician colleagues. 

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Payment policies may be driving down utilization of key interventional radiology procedure

Fewer than 2% of hospitalized inpatients underwent ablation for renal cell carcinoma, despite its lower cost and other benefits.