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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ACR Commission on Breast Imaging objects to text included in Breast Cancer Screening PDQ

The American College of Radiology (ACR) Commission on Breast Imaging has sent a letter to the Physician Data Query (PDQ) Editorial Board objecting to specific language included in the recently updated Breast Cancer Screening PDQ.

CMS approves Oklahoma proposal for value-based Medicaid agreements with drug manufacturers

CMS has issued an approval to Oklahoma to negotiate value-based supplemental rebate agreements directly with drug manufacturers, which could produce extra rebates for state, should clinical outcomes not be achieved.

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ACR calls out ‘overly biased’ argument made by CMS in IPPS proposed rule

The American College of Radiology (ACR) has submitted written comments to CMS about the Inpatient Prospective Payment System (IPPS) proposed rule for Calendar Year 2019.

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CMS policy to reduce hospital-acquired infections has minimal impact on reimbursement

New research published in Infection Control & Hospital Epidemiology suggests the 2008 CMS’ policy, Hospital Inpatient Prospective Payment System (IPPS), which penalizes hospitals for hospital-associated conditions (HAC) present at the time of the patients’ admission to the hospital has had a minimal impact on hospital reimbursement.

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ACR opposes ‘surprise bill’ regulation in proposed Medicare IPPS rule

The American College of Radiology (ACR) submitted written comments to CMS, taking issue with its proposed Inpatient Prospective Payment System (IPPS) rule for 2019.

Medicaid benefits could be cut if work requirements aren't fixed, implemented quickly

On Friday, a federal judge denied Kentucky’s move to impose work requirements on some Medicaid recipients. Now, one Kentucky official claims benefits will be cut if this policy isn't fixed and implemented quickly.

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Kentucky Medicaid work requirements shot down by federal judge

Kentucky was set to become the first state in the U.S. to impose work requirements on Medicaid recipients. But a federal judge blocked the move, which was set to take effect on Sunday—claiming the Trump administration didn’t properly consider the policy’s effect on the program’s intended aim to provide medical coverage to at-risk populations.

9 accused of submitting $950M in fraudulent health insurance claims

Federal prosecutors in California announced charges against nine individuals—including orthopedic surgeons, chiropractors and a C-suite executive—for allegedly running a 15-year scheme that submitted nearly $1 billion in fraudulent health insurance claims to the federal government, California and private insurers.