Policy and Legislation

While much of the focus now is on Donald Berwick's replacement at the Centers for Medicare & Medicaid Services, some in the industry are reflecting on Berwick's departure and the larger issues it signifies: a political system that is too polarized to be effective.

The California Hospital Association last week petitioned a federal district court to grant a preliminary injunction against California's Medicaid program, called Medi-Cal, to prevent it from making 10 percent reimbursement cuts primarily affecting hospital-based skilled nursing facilities.

The Senior Medicare Patrol (SMP) has been given a $9 million grant from the Centers for Medicare & Medicaid Services (CMS) to continue combating Medicare fraud.

One of the country's largest drugmakers, Merck, will pay nearly $1 billion to settle criminal and civil charges related to its marketing of the painkiller Vioxx the Justice Department announced Tuesday.

The U.S. Department of Health and Human Services yesterday issued its first public rebuke under its new powers to review health insurance increases greater than 10 percent, calling on Everence Insurance in Pennsylvania to cut its planned premium increases to 5,000 members.

Kaiser Permanente is suing the California Nurses Association saying it violated terms of the current contract when the union authorized a sympathy strike last September.

In an effort to provide some sense of certainty about an ACO's ability to reach the so-called triple aim of reducing cost, improving quality and enhancing patient experience, the National Committee for Quality Assurance (NCQA) released on Monday its standards and guidelines which are the basis of its ACO accreditation program.

As policymakers and employers struggle with the rising costs of healthcare, there's a direct solution to cutting healthcare costs while not sacrificing quality of care says the Institute for Women's Policy Research: paid sick days.

Even with the major revisions to the final regulations for accountable care organizations (ACOs), uncertainty remains. The risks and technical challenges hospitals will face in transforming to the ACO model are daunting and require consideration.

Occupy Healthcare, an offshoot movement of Occupy Wall Street, is not covered as much as its parent, even though it is united in effort and, unlike the better known movement, has clear demands.