Legal / Regulatory / Risk Management

Latest Headlines

Latest Headlines

System provides doctors with instant drug history information

Doctors cite myriad reasons for not taking advantage of state prescription drug databases, even though health officials encourage the use of such tools more than ever in light of the country's opioid crisis.  

Keep proposed MACRA changes in perspective

Worries over the consequences of value-based payment methodologies in the Medicare Access and CHIP Reauthorization Act obscure significant improvements the rule makes over the status quo, writes Bob Doherty, senior vice president of Government Affairs and Public Policy at the American College of Physicians, in an article published in  MedPage Today.

Anthem, Cigna squabbles could threaten proposed merger

Tensions are rising between potential merger partners Anthem and Cigna, which could only make it more difficult for the two health insurance companies to win over federal regulators.  

Highmark's risk corridor litigation: Other insurers could follow suit

After Highmark sued the federal government for $224 million in unreimbursed losses from its Affordable Care Act policies, there are signs other insurers may consider filing similar suits.  

Healthcare device data thefts focus of federal court case

A 12-count indictment against an engineer illustrates more needs to be done to protect and store healthcare data.

With end of ICD-10 grace period looming, docs must be mindful of code specificity

As the end of the first year under ICD-10 fast approaches, physicians who filed claims under the Medicare Part B physician fee schedule must be mindful that the end one-year grace period from post-payment reviews also looms.

House bill would factor socioeconomic factors into readmission penalties

A bipartisan bill introduced in Congress this week would amend the Centers for Medicare & Medicaid Services' readmissions program to factor in patients' socioeconomic status to prevent hospitals from receiving penalties for circumstances beyond their control.

House Republicans propose 'world's greatest' ACA replacement plan

Rep. Pete Sessions (R-Texas) and Sen. Bill Cassidy (R-La.) have unveiled an ACA replacement they call the "World's Greatest Healthcare Plan." 

Scuttled Staples-Office Depot deal: Bad news for health insurer mergers

The demise of a proposed deal between Staples and Office Depot may be yet another sign that the two pending health insurer mergers are in for a tough regulatory review.  

Sharp divide over plan to curb drug spending

Lawmakers, physicians and patient advocates voiced a wide range of reactions to the Obama administration's proposed drug reimbursement model in a House subcommittee hearing this week, with some arguing the demonstration project should be scrapped entirely and others advocating for slight tweaks to address provider concerns.