Health Care Quality Digest

Prior authorization and other regulatory burdens have increased since last year, practices tell MGMA

Fierce Healthcare

NOVEMBER 13, 2023

Nine in 10 polled medical practices say their regulatory burden has increased over the past year with prior authorization, audits and appeals, the Medicare Quality Payment Program (QPP) and require | The latest annual poll of practices' regulatory burden outlined prior authorization, audits and appeals, Medicare QPP and other leading pain points (..)

Medicare

Elevance, BCBSLA pause $2.5B merger amid regulatory scrutiny

Health Care Dive

SEPTEMBER 26, 2023

The health insurers originally expected their merger to close before the end of 2023, but have hit snags receiving the regulatory green light in Louisiana.

JAPAC Drug Development: Navigating Safety & Regulatory Requirements

HIT Consultant

APRIL 15, 2024

Director of Regulatory Affairs and Drug Development Solutions, IQVIA Asia Pacific The biopharmaceutical market within the Japan and Asia-Pacific (JAPAC) region has grown consistently since 2010, specifically for emerging biopharmas (EBPs). Japan’s PMDA has many safety and regulatory distinctions.

Pharmaceuticals

Pharmaceuticals Patient Safety Accountability Integration

Healthcare dealmaking 'resilient' despite regulatory, economic headwinds: PwC

Fierce Healthcare

JUNE 21, 2023

Even in the face of substantial headwinds, dealmaking in the healthcare industry hasn't fallen off, according to a new analysis from PwC. Even in the face of substantial headwinds, dealmaking in the healthcare industry hasn't fallen off, according to a new analysis from PwC.

Healthcare

CVS expects to close Oak Street Health deal by July as acquisition clears regulatory obstacle

Fierce Healthcare

MARCH 31, 2023

CVS expects to close Oak Street Health deal by July as acquisition clears regulatory obstacle hlandi Fri, 03/31/2023 - 12:05

Emerging regulatory standards are paving the way for a new era: Unified experiences will be healthcare’s future

Health Care Dive

DECEMBER 5, 2022

The impending changes to prior authorization processing aren’t minor, and they aren’t the only types of regulatory transformation that healthcare organizations will need to navigate in the months and years to come.

Healthcare

Psychedelic Lobbying and Regulatory Capture

Bill Of Health

MARCH 4, 2024

By Vincent Joralemon Psychedelic companies and advocacy groups are spending substantial resources to influence regulatory policy, shaping what the blossoming field will ultimately cohere into. When that leads to undue influence, the result is known as “regulatory capture.” What is Regulatory Capture?

Regulations

Regulations Pharmaceuticals

FTC's backlog is delaying regulatory review of Beaumont-Spectrum merger, systems say

Fierce Healthcare

SEPTEMBER 27, 2021

FTC's backlog is delaying regulatory review of Beaumont-Spectrum merger, systems say. Mon, 09/27/2021 - 12:15.

Actuaries project future virus surges, end of regulatory flexibility key drivers in 2022 rates

Fierce Healthcare

SEPTEMBER 2, 2021

Actuaries project future virus surges, end of regulatory flexibility key drivers in 2022 rates. Thu, 09/02/2021 - 13:33.

Surprise billing compliance 'very daunting,' regulatory experts say

Health Care Dive

APRIL 7, 2022

The bill is best known for its signature achievement, but there are lesser known requirements that are difficult to put into practice, experts told Healthcare Dive.

Healthcare

A Cigna-Humana merger could face a long regulatory delay. But it might get approved.

Health Care Dive

DECEMBER 4, 2023

As rumors swirl that the two major health insurers are inching toward a merger, experts say antitrust agencies have grounds to block a deal — but may not be successful.

Hospitals push FTC to withdraw 'largely unnecessary' updates to pre-merger regulatory filings

Fierce Healthcare

SEPTEMBER 6, 2023

The American Hospital Association (AHA) is among those pushing back against the Federal Trade Commission’s (FTC's) plans to update pre-merger notification requirements, calling the proposal “a subs | "There is no need to subject hospitals to burdensome rules aimed at other sectors of the economy,” the AHA wrote of amendments to the Hart-Scott-Rodino (..)

Hospitals

CVS-Oak Street deal clears regulatory hurdle as antitrust waiting period expires

Health Care Dive

MARCH 30, 2023

Oak Street also announced on Thursday it’s canceling its annual board meeting following the CVS deal, which is expected to close in the first half of the year. Oak Street stockholders will meet on April 28 to vote on the sale.

RFX Solutions Raises $9M for All-in-One Healthcare Regulatory Compliance Platform

HIT Consultant

APRIL 19, 2024

– The user-friendly SaaS platform empowers healthcare facilities to navigate the complexities of regulatory requirements efficiently and effectively.

Healthcare

Regulatory burdens strapped medical practices over the past year, MGMA finds

Health Care Dive

OCTOBER 27, 2021

Prior authorization requirements were the most frequently cited hurdle, while requirements for Medicare's Quality Payment Program and COVID-19 workplace mandates tied for second, a survey by the medical practices group found.

Medicare

Readers Write: 2024 Regulatory Changes and their Impact

HIStalk

DECEMBER 20, 2023

2024 Regulatory Changes and their ImpactBy Vatsala Kapur Vatsala Kapur,

Michigan, Vermont Blues plans finalize merger after securing key regulatory approval

Fierce Healthcare

OCTOBER 12, 2023

Blue Cross Blue Shield of Michigan (BCBSM) and Blue Cross Blue Shield of Vermont (BCBSVT) have closed their merger deal after securing the OK from regulators in the Green Mountain State. |

Regulations

Healthcare Landscape 2023: Navigating the Shifting Sands of Physician Collectives, Reimbursement Rates, and Regulatory Ripples

HIT Consultant

NOVEMBER 19, 2023

Regulatory Ripples: The CMS Proposals The regulatory realm hasn’t been devoid of action either. For those in the industry contemplating bringing negotiation consultants onboard, a word of caution: diligence is key. The landscape is rife with entities that might overpromise, so thorough vetting is non-negotiable.

Healthcare

Healthcare Hospitals

FDA Guidance on using Real-World Data for regulatory Decision-Making

Healthcare ECONOMIST

SEPTEMBER 24, 2023

Last month, FDA released guidance on the use of real-world evidence to support regulatory decision-making for new drugs. Below are some of the key points from this guidance document: Legislative mandate.

Regulations

Regulations Hospitals Pharmaceuticals

Given Regulatory Uncertainty, Hospital-At-Home Models Are Losing Momentum

Home Health Care

SEPTEMBER 13, 2022

With regulatory uncertainty moving forward, the hospital-at-home momentum has been put on pause – but not because of patient preference or provider enthusiasm. But many have not begun to do so given the regulatory cliff they face. Those providers did so, and now they’re wondering what comes next.

Hospitals

Hospitals Hospice Care Home Care Nursing

Readers Write: Navigating the Telehealth Regulatory Labyrinth

HIStalk

NOVEMBER 13, 2023

Navigating the Telehealth Regulatory LabyrinthBy Sheeza Hussain Sheeza Hussain is.

John Muir Health, Tenet Healthcare nix $143M hospital deal after regulatory pushback

Fierce Healthcare

DECEMBER 19, 2023

John Muir Health and Tenet Healthcare have chosen to call off a hospital deal that had been contested by the Federal Trade Commission (FTC) and the State of California, eliciting a quick victory la | John Muir had planned to buy out Tenet's 51% stake in San Ramon Regional Medical Center, a deal the FTC and the State of California said would give (..)

Hospitals

Hospitals Healthcare

M&A: ArisGlobal Acquires SPORIFY to Expand Regulatory Solutions

HIT Consultant

MAY 18, 2023

About SPORIFY SPORIFY provides consistent and ISO IDMP-compliant SPOR data to feed regulatory activities across the product life cycle, enabling more informed, proactive regulatory decisions to benefit public health and safety.

Life Sciences

Life Sciences Pharmaceuticals Patient Safety Regulations

Home-Based Care Stakeholders Break Down ‘Uncertain’ Legislative, Regulatory Landscapes

Home Health Care

APRIL 23, 2022

With more eyes than ever on home-based care, there are a number of legislative and regulatory developments that will be critical for providers to stay on top of. Looking ahead, John Olajide, the president and CEO of Axxess, believes its imperative for providers to proactively engage in policy, regulatory and reimbursement discussions. “I

Medicaid

Medicaid Medicare Home Care Quality of Care

As The ‘Premium Dollar Holder,’ Chapters Health Sidesteps Home Health Care’s Difficult Regulatory Landscape

Home Health Care

JUNE 23, 2023

Ultimately, he sees Chapters Health’s strategy of taking on risk as a way to solve one of home health’s most persistent challenges — the regulatory environment. The regulatory environment is terribly challenging,” he said. That level of freedom has been how we have pursued the consistently nagging nature of regulatory burden.”

Accountability

Accountability Population Health Medicare Integration

FTC’s enforcement action against GoodRx unveiled a new regulatory threat. Should digital health apps be concerned?

Health Care Dive

FEBRUARY 13, 2023

The order suggests the regulator is willing to use every tool in its tookit to tamp down on sensitive data sharing as medical care turns increasingly online.

Regulations

Nearing Regulatory Cliff, Hospital-at-Home Stakeholders Throw Support Behind Waiver Extension

Home Health Care

MARCH 21, 2022

There is a need, from a regulatory standpoint, to avoid these programs ending if the waiver goes away.”. The post Nearing Regulatory Cliff, Hospital-at-Home Stakeholders Throw Support Behind Waiver Extension appeared first on Home Health Care News. Sign up for HHCN + to read this exclusive content. Individual Membership. 400 per year.

Hospitals

Hospitals Medicaid Medicare

The Top Legal, Regulatory Issues Home-Based Care Providers Are Facing In 2023

Home Health Care

MAY 26, 2023

There are a number of key issues that home-based care providers looking to navigate legal and regulatory hurdles need to keep their eye on – some old, and some new. For providers, returning to pre-pandemic regulatory standards will be a major compliance effort moving forward, according to Barnett. “If

Home Care

Home Care Law Firms Nursing Medicaid

Elevance Health to acquire Kroger Specialty Pharmacy

Fierce Healthcare

MARCH 19, 2024

The grocery chain announced Monday that an agreement is in place, saying it's expected to close in the back half of 2024 pending regulatory approvals. Elevance Health has inked a deal to acquire Kroger Specialty Pharmacy. |

Rural Emergency Hospitals: Legislative and Regulatory Considerations for States

NASHP

AUGUST 30, 2023

To learn more, visit NASHP’s guide of legislative and regulatory considerations for states. NASHP developed a guide of legislative and regulatory considerations to assist states that wish to pursue the REH model. The post Rural Emergency Hospitals: Legislative and Regulatory Considerations for States appeared first on NASHP.

Hospitals

Hospitals Regulations Medicare Medicaid

The Public Health Emergency Proved Certain Regulatory Red Tape Was Unnecessary

Home Health Care

JANUARY 31, 2023

The post The Public Health Emergency Proved Certain Regulatory Red Tape Was Unnecessary appeared first on Home Health Care News. “Maybe that process isn’t something to keep layering on top of, in order to achieve an end that you can sometimes get to in more efficient ways.”

Nursing

Nursing Primary Care Medicare Home Care

CMS Hopes to Support Home-Based Care with More Payment, Regulatory Flexibilities

Home Health Care

OCTOBER 20, 2021

Among its key pillars, the refresh calls for greater payment and regulatory flexibilities supporting the provision of home- and community-based care. The post CMS Hopes to Support Home-Based Care with More Payment, Regulatory Flexibilities appeared first on Home Health Care News.

Accountable Care

Accountable Care Accountability Medicare Medicaid

Northwell Health, Nuvance Health unveil 28-hospital merger deal

Fierce Healthcare

FEBRUARY 28, 2024

The $18 billion combination, which still requires regulatory signoffs, would give Northwell a foothold in Connecticut and promises "significant investments" for Nuvance.

Hospitals

Rural Emergency Hospitals: Guide to Legislative and Regulatory Considerations for States

NASHP

AUGUST 30, 2023

To learn more about this model act, check out our blog post, Rural Emergency Hospitals: Legislative and Regulatory Considerations for States. Drafting Note : Use the title of the chief regulatory official for hospital licensure whenever the terms “commissioner” appears. Commissioner” means the Commissioner of the Department of Health.

Hospitals

Hospitals Regulations Federal Healthcare Nursing

Trends shaping the business of health insurance in 2024

Health Care Dive

JANUARY 16, 2024

Medicare Advantage enrollment will swell, with fewer sweeping regulatory changes. The uninsured rate will rise. Major pharmacy benefit managers will launch more transparent products. Here’s what experts see coming down the pike for 2024.

Medicare

Steward to sell physician group to UnitedHealth’s Optum Care

Health Care Dive

MARCH 27, 2024

The proposed deal could face regulatory scrutiny, Massachusetts officials say.

General Catalyst's new health system company to acquire Summa Health

Fierce Healthcare

JANUARY 17, 2024

The deal still requires regulatory approval. . | The venture capital firm's deal would make the Ohio nonprofit a wholly owned subsidiary of the recently launched Health Assurance Transformation Corp.

Healthcare bankruptcies are rising. Here are five major filings so far in 2023.

Health Care Dive

NOVEMBER 22, 2023

Bankruptcies have spiked this year as federal COVID-19 funding lapsed and heightened interest rates, regulatory changes and labor shortages squeezed the sector.

Healthcare

Regulatory Barriers Present Challenges for At-home Birth

Bill Of Health

APRIL 4, 2022

Regulatory hurdles limit opportunities to practice for midwives. The post Regulatory Barriers Present Challenges for At-home Birth appeared first on Bill of Health. It’s fair for insurance companies to want women to choose birth methods that are perceived to be of the lowest risk.

Hospitals

Atlantic Health System, Saint Peter’s Healthcare System look to merge

Health Care Dive

FEBRUARY 1, 2024

The letter of intent comes about a year and half after a proposed deal between Saint Peter’s and RWJBarnabas Health fell apart following regulatory scrutiny.

Healthcare

2024 Outlook: The cybersecurity trends health system leaders need to know

Fierce Healthcare

DECEMBER 15, 2023

Shifting targets, indirect angles of attack and increasing regulatory expectations await hospitals and health systems in the coming year, cybersecurity experts say. The danger of cybercrime and security breaches looms over the healthcare industry like a slow-moving storm.

Hospitals

Hospitals Healthcare

3 Lessons Learned from Pandemic-Era Clinical Development Regulatory Practices

HIT Consultant

AUGUST 18, 2021

Here’s a look at what we’ve learned from COVID-19 era regulatory practices in clinical development. The rapid adoption of decentralized and hybrid clinical study design spurred by the pandemic will present new regulatory challenges for the foreseeable future.

Regulations

Regulations Pharmaceuticals Integration Medical Technology

RWE: Supporting Regulatory Submissions with Real-World Evidence

HIT Consultant

SEPTEMBER 14, 2021

Along with advances in the availability and quality of real-world data (RWD) from sources like electronic health records (EHRs) , registries, medical claims and pharmacy data, the Cures Act has been a catalyst for increased emphasis on using RWE in clinical and regulatory decision-making. The future of RWE.

Life Sciences

Life Sciences Regulations Health Data Healthcare

Google launches AI-backed search-and-answer tool for doctors

Health Care Dive

MARCH 12, 2024

Vertex AI Search for Healthcare comes as the industry awaits a regulatory structure from the federal government around the use of AI in healthcare.

Doctors

Doctors Healthcare

Prior authorization and other regulatory burdens have increased since last year, practices tell MGMA

Elevance, BCBSLA pause $2.5B merger amid regulatory scrutiny

Trending Sources

JAPAC Drug Development: Navigating Safety & Regulatory Requirements

Healthcare dealmaking 'resilient' despite regulatory, economic headwinds: PwC

CVS expects to close Oak Street Health deal by July as acquisition clears regulatory obstacle

Emerging regulatory standards are paving the way for a new era: Unified experiences will be healthcare’s future

Psychedelic Lobbying and Regulatory Capture

FTC's backlog is delaying regulatory review of Beaumont-Spectrum merger, systems say

Actuaries project future virus surges, end of regulatory flexibility key drivers in 2022 rates

Surprise billing compliance 'very daunting,' regulatory experts say

A Cigna-Humana merger could face a long regulatory delay. But it might get approved.

Hospitals push FTC to withdraw 'largely unnecessary' updates to pre-merger regulatory filings

CVS-Oak Street deal clears regulatory hurdle as antitrust waiting period expires

RFX Solutions Raises $9M for All-in-One Healthcare Regulatory Compliance Platform

Regulatory burdens strapped medical practices over the past year, MGMA finds

Readers Write: 2024 Regulatory Changes and their Impact

Michigan, Vermont Blues plans finalize merger after securing key regulatory approval

Healthcare Landscape 2023: Navigating the Shifting Sands of Physician Collectives, Reimbursement Rates, and Regulatory Ripples

FDA Guidance on using Real-World Data for regulatory Decision-Making

Given Regulatory Uncertainty, Hospital-At-Home Models Are Losing Momentum

Readers Write: Navigating the Telehealth Regulatory Labyrinth

John Muir Health, Tenet Healthcare nix $143M hospital deal after regulatory pushback

M&A: ArisGlobal Acquires SPORIFY to Expand Regulatory Solutions

Home-Based Care Stakeholders Break Down ‘Uncertain’ Legislative, Regulatory Landscapes

As The ‘Premium Dollar Holder,’ Chapters Health Sidesteps Home Health Care’s Difficult Regulatory Landscape

FTC’s enforcement action against GoodRx unveiled a new regulatory threat. Should digital health apps be concerned?

Nearing Regulatory Cliff, Hospital-at-Home Stakeholders Throw Support Behind Waiver Extension

The Top Legal, Regulatory Issues Home-Based Care Providers Are Facing In 2023

Elevance Health to acquire Kroger Specialty Pharmacy

Rural Emergency Hospitals: Legislative and Regulatory Considerations for States

The Public Health Emergency Proved Certain Regulatory Red Tape Was Unnecessary

CMS Hopes to Support Home-Based Care with More Payment, Regulatory Flexibilities

Northwell Health, Nuvance Health unveil 28-hospital merger deal

Rural Emergency Hospitals: Guide to Legislative and Regulatory Considerations for States

Trends shaping the business of health insurance in 2024

Steward to sell physician group to UnitedHealth’s Optum Care

General Catalyst's new health system company to acquire Summa Health

Healthcare bankruptcies are rising. Here are five major filings so far in 2023.

Regulatory Barriers Present Challenges for At-home Birth

Atlantic Health System, Saint Peter’s Healthcare System look to merge

2024 Outlook: The cybersecurity trends health system leaders need to know

3 Lessons Learned from Pandemic-Era Clinical Development Regulatory Practices

RWE: Supporting Regulatory Submissions with Real-World Evidence

Google launches AI-backed search-and-answer tool for doctors

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