The agency estimates that there were $28.83 billion in improper payments to traditional Medicare, which it estimates are down from $31.7 billion in 2024. The Center for Medicaid & Medicare Services acknowledges improper payments are not...
An Arizona Medicaid contract dispute involving one of the state’s largest autism therapy providers and one of the largest Medicaid health plans is escalating into litigation, raising questions about network adequacy, reimbursement pressure, and continuity of care for children receiving applied behavior analysis services.
According...
On Tuesday, senior members of Congress announced a deal to fund the government for 2026. The bill would resurrect a number of bipartisan measures that were poised to pass in late 2024 but were undermined by then-President-elect Donald Trump.
The new bill would extend Medicare telehealth and hospital-at-home waivers for two and five...
Last week, President Donald Trump introduced "The Great Healthcare Plan," a policy framework that aims to lower drug prices and cut medical costs for consumers.
In a video address, President Trump called on Congress to enact his Great Healthcare Plan and consolidate the various Trump-era health-adjacent initiatives into a single law....
A Senate report shows that UnitedHealth Group (UHG), the parent company to the nation's and Arizona's largest Medicare Advantage (MA) insurer, UnitedHealthcare (UHC), is artificially inflating the risk adjustment scores of its MA members in order to achieve higher reimbursement from the Medicare program.
The report is based on 50,000...
All eyes are on UnitedHealth Group's last quarterly financial report of 2025 (Q4). The insurance giant's financials are expected to signal the relative strength of the economic sector's effort to prop up much of the job growth in the American economy and respond to aggressive threats from the Trump administration.
UnitedHealth Group...Arizona News
A day after termination notices went out to thousands of substance use disorder and mental health programs nationwide, the federal government reversed course and reinstated the funding.
The abrupt cancellations at the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) would have affected roughly 2,700...
As Medicare Advantage (MA) data watchers wait until mid-February for CMS to release January enrollment figures, the Medicare Payment Advisory Commission has already completed a rearview analysis of the 2025 MA market and provides insights into 2026.
In its annual report, MedPAC confirms three familiar but still consequential...
The new pediatric emergency department at Banner Children’s at Diamond Children’s Medical Center in Tucson, expands emergency capacity at southern Arizona’s only Level II pediatric trauma center and strengthens access to specialized care for children across the region.
The new pediatric ED features 22 treatment rooms, a...Arizona News
HonorHealth, a Valley-based nonprofit healthcare system serving more than five million people across the greater Phoenix metropolitan area, continues to lead the state in critical care nursing excellence recognition.
HonorHealth now has 12 Beacon-recognized nursing units across five medical centers, representing 75% of the 16...
Arizona Gov. Katie Hobbs released her proposed $17.7 billion FY2027 executive budget last Friday, quickly drawing fire from Republican lawmakers and setting up negotiations at the state Capitol over taxes, Medicaid funding and administration, SNAP benefits, housing support, education funding, and artificial intelligence as well as how to...
Following the Department of Health and Human Services' overhaul of the childhood vaccine schedule, more details are emerging about what the new recommendations entail and how they could impact providers and patients.
When first announced, much of the Center for Disease Control and Prevention's new guidance was unclear, but this week...Arizona News
This week, the so-called "superflu" continues to drive an elevated case rate in Arizona and neighboring states, but other seasonal illnesses are also on the rise and the measles outbreak remains ongoing.
There have been a total of 223 measles cases in Arizona since the outbreak began, largely concentrated around the town of Colorado...National News
Healthcare software giant Epic Systems has filed a lawsuit against competitor health information network Health Gorilla and its clients for improperly accessing hundreds of thousands of patient records managed by the company.
The lawsuit was filed on Tuesday morning in California and accused Health Gorilla of fraud and breach of...
The Centers for Disease Control and Prevention (CDC) has updated the childhood immunization schedule to reduce the number of diseases prevented by routine vaccinations from 17 to 11.
The announcement was made on Monday and signals a major shift in federal vaccination policy guided by Health and Human Services (HHS) Secretary Robert F....
January 15 is the last day to enroll in a health plan offered through the Affordable Care Act (ACA) Marketplace, and preliminary numbers show enrollment has dropped substantially year-over-year.
In a fact sheet published on Monday, the Centers for Medicare and Medicaid Services boasted 22.8 million consumers enrolled in 2026 coverage...
The Supreme Court has passively affirmed a Fifth Circuit decision to dismiss a case, siding with employers over COVID-19 era vaccine mandates.
The Supreme Court declined to hear the case, Bridges et al. v. The Methodist Hospital et al., by not granting certiorari in an orders list published this week, Inside Health Policy explains....
The new platform, called ClaimsCore, is intended to unify the Multi-Carrier System, the Fiscal Intermediary Shared System, ViPS Medicare System and the Common Working File.
ClaimsCore is designed by the feds to deliver immediate improvements to the Medicare experience while enabling deeper, future transformation fit for today's...National News
The 2026 poverty guidelines will be on public display at the Federal Register soon, however, The Hertel Report has compiled the guidelines from ASPE announcement and provides a year-over-year comparison.
Full year-over-year charting isn't yet available, but below are the 100% FPL rates per family size for 2026 along with the YOY...National News
Less than two years after closing its patient care clinics and selling its telehealth services, Walmart is re-entering the healthcare space with a digital platform that relies on third-party providers and its national pharmacy footprint rather than employed clinicians.
As reported by Health Exec, Walmart avoided specific enrollment or...News
Terminated funding awards could total as high as $1.9 billion across as many as 2,800 awards, representing roughly a quarter of the agency’s annual budget. Last year, Arizona tribes, universities, non-profits, and several state agencies received about $203M in SAMHSA awards; AHCCCS received the bulk of the grants, earning about $165M...National Reports & Surveys
Arizona’s overdose crisis is easing but far from resolved, a dynamic that mirrors national trends highlighted in a new report from the American Medical Association.
During the height of the COVID-19 pandemic, opioid-related deaths in Arizona remained consistently above 2,000 per month from mid-2021 through the end of 2023. By...Arizona News
HonorHealth has opened HonorHealth Complete Care – Lake Pleasant, a new Peoria facility combining a full-service emergency department and urgent care for faster triage and clearer care pathways for patients.
Combined ER–urgent care facilities are emerging as a strategic access play in fast-growing suburban markets, offering health...Arizona News
The 2026 Arizona legislative session will begin shortly, and Republican Senator Wendy Rogers has again introduced a bill that would require Arizona hospitals to ask patients about their immigration status during intake.
This is the second year that Rogers has introduced the bill, arguing that the state needs to know how much is spent...Arizona News
Last week, the U.S. Department of Health and Human Services (HHS) announced the awards for the Trump administration's Rural Health Transformation Program (RHTP), which is meant to bolster rural health systems in the wake of substantial cuts to the Medicaid program. Arizona is set to receive $167 million, about two-thirds of what it...
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