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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1 in 7 patients receive surprise medical bills

Roughly 1 in 7 patients—or 14.5 percent of hospital admissions in the U.S.—experience surprise medical billing despite seeking care at an in-network facility, according to an analysis by the Health Care Cost Institute (HCCI).

Medicare FFS amassed $23.2B in improper payments in 2017

Medicare fee-for-service (FFS) programs racked up an estimated $23.2 billion in improper payments in 2017, according to CMS data—almost $19 billion more than Medicaid FFS’ $4.3 billion and a red flag that the program’s documentation requirements might not be up to par.

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Purdue Pharma reaches $270M settlement in opioid case

Purdue Pharma agreed to a $270 million settlement March 26 to help battle Oklahoma’s opioid crisis after a slew of lawsuits threatened to edge the company into bankruptcy.

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Reporting update: PI-RADS version 2.1 released to public

The PI-RADS Steering Committee, a collaboration between the American College of Radiology (ACR), European Society of Urogenital Radiology and AdMeTech Foundation, has published a new update to its Prostate Imaging Reporting and Data System (PI-RADS).

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FDA proposed rule ‘modernizes’ mammography screening, includes breast density reporting

The FDA announced Wednesday, March 27, that it is taking action to “modernize” breast cancer screening in the United States by amending the Mammography Quality Standards Act of 1992 with a new proposed rule.

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‘All-out war’: Trump administration supports ruling to invalidate entirety of Obamacare

The Trump administration filed a notice March 25 supporting a federal judge’s ruling that the Affordable Care Act should be thrown out in its entirety—a sharp pivot from the administration’s previous position that only parts of the law should be eradicated.

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CVS shares down 30% after Aetna merger

CVS Health’s merger with managed care company Aetna has resulted in lower stock shares and some financial stress, but strategies to reduce unnecessary medical expenses and capitalize on trends like cannabis legalization might ease some of that discomfort, CNBC reported March 21.

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Final 2019 open enrollment report: ACA sign-ups dip to 11.4M

CMS issued its final Health Insurance Exchanges 2019 Open Enrollment Report on March 25, touting stabilized premiums and extended “grandmother” policies amid sign-ups that numbered 300,000 fewer than last year.