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. 

Cybercrime

Primera Blue Cross hit with $6.85M penalty, corrective action plan for HIPAA violations

The resolution represents the second largest payment to resolve a HIPAA investigation in OCR history. It also includes a robust corrective action plan that calls for, among other things, two years of monitoring.

September 29, 2020
Canada

US residents may soon be buying drugs from Canada—legally

The Trump Administration’s main aim is widening consumer access to lower prices.

September 25, 2020
Seema Verma WaPo

Washington implores parents, providers to catch kids up on regular doctor visits

So many parents have held children back from visiting clinicians’ offices during the COVID crisis that CMS is issuing an urgent call to action: Please hold them back no more.

September 24, 2020

Nursing homes using hospitals as middlemen to bounce low-reimbursement, high-maintenance residents

A common tactic is sending off Medicaid-covered seniors with dementia following emergency “psychotic” episodes. When psychiatric wards and hospitals quickly discharge the patients, the nursing homes refuse to take them back in.

September 21, 2020
Hospital Costs

Rand study suggests hospitals are exorbitantly overpaid by private insurers; AHA reacts

In real dollars, these payers’ combined savings would have nearly reached $20 billion just in 2018, the analysis shows.

September 21, 2020

Lawmaker ‘deeply concerned’ over $250M HHS contract for coronavirus-related PR work

Rep. Frank Pallone Jr., D-N.J., worries the agency is using taxpayer funds to fuel the commander-in-chief’s bid for a second term. 

September 14, 2020
Twenty-three percent of cardiologists have a net worth of more than $5 million, No. 5 among all specialties, according to a new report. A majority of cardiologists also said they have had no significant financial losses in the last year. What are cardiologists paid? How much do cardiologists make?

Alleged Stark violations, kickbacks to cost hospital $50M

A 223-bed acute care institution with a medical staff of nearly 300 physicians has agreed to pay $50 million over allegations it deliberately submitted ineligible claims to Medicare and profited handsomely by these actions.  

September 10, 2020
Hurdles

4 hurdles thwarting AI from conquering clinical practice

AI will not earn a place in the daily practice of medicine until its developers definitively answer some pressing questions on fitness and appropriateness.

September 9, 2020

Around the web

Five of the largest U.S. medical societies focused on cardiovascular health are one step closer to seeing their paradigm-shifting proposal become a reality.

The Society for Cardiovascular Angiography & Interventions and Society of Thoracic Surgeons have both shared statements in support of the ban, which is already being challenged in court. The American Hospital Association, meanwhile, opposes the policy shift, saying it “errs by seeking to create a one-size-fits-all rule”

Alison Bailey, MD, co-chair of the business of cardiology sessions at ACC.24, emphasized that reimbursement cuts can have a long-term negative impact on patient. 

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