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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$5,751 for an ice pack? Hefty bills await patients just for walking into ER

In the latest article in Vox’s series on hospital billing practices, Jessica Pell told a story that isn’t a one-off case: She went to an emergency room (ER), received a minimal amount of help and still got saddled with a massive bill.

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Q&A: MITA’s Peter Weems discusses key policies affecting the medical imaging industry

Peter Weems, director of policy and strategy for the Medical Imaging and Technology Alliance (MITA), spoke with Radiology Business about some of the biggest issues MITA is keeping a close eye on right now.

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Uninsured rate on the rise—up 4M since 2016

Years of gains in insurance coverage since the Affordable Care Act (ACA) are beginning to reverse, according to a new report from the Commonwealth Fund which found 15.5 percent of working age adults are uninsured, an increase of about four million people since 2016.

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Molina won’t rule out return to certain ACA markets

Managed care and Affordable Care Act (ACA) exchange insurer Molina Healthcare said its first quarter profits “exceed expectations” after raising premiums for its marketplace plans by about 60 percent and isn’t ruling out returning to markets in Utah and Wisconsin, where it previously offered coverage.

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Maine’s stalled Medicaid expansion heading to court

Maine became the first state to approve Medicaid expansion at the ballot box. Despite 59 percent of voters approved of expansion, Gov. Paul LePage has taken several steps which have stalled its implementation.

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Envision’s lawsuit against UnitedHealthcare dismissed

Envision had sued the insurer in March, alleging UnitedHealthcare “unilaterally” negotiated payment rates and failed to add Envision physicians to its network after the acquisition of AmSurg in 2016. UnitedHealthcare argued Envision’s emergency room billing practices were “egregious,” but also said the lawsuit itself was a violation of the arbitration provision in their contract.

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FDA releases finalized Clinical Trial Imaging Endpoint Process Standards

The FDA released a finalized industry guidance April 27 that will help sponsors optimize the quality of imaging data obtained in clinical trials that support approval of drugs and biological products.

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3 things to know about CMS payment rules for skilled nursing, inpatient rehab, hospices

CMS published several of its annual proposed Medicare payment rules on Friday afternoon, covering a slew of facilities like nursing homes, hospices, inpatient rehabilitation and psychiatric hospitals. As predicted, the proposed rule also included regulatory changes in line with CMS initiatives on reducing administrative burden and granting patients easier access to their own data.