Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. is settling into his new role as firings within the agency continue to disrupt the agency.
The Reduction in Force (RIF) initiative was announced to have reduced the U.S. Department...CMS Rules
The Centers for Medicare and Medicaid Services issued a proposed rule for the Medicare inpatient prospective payment system (IPPS) for fiscal year (FY) 2026. The rule includes a proposed pay bump of 2.4% for hospitals.
CMS said that the rate reflects a 3.2% projected hospital market basket increase with a 0.8% productivity adjustment...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) has proposed a rule under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for Fiscal Year (FY) 2026.
The agency proposes updating the payment rates by 2.6% based on the IRF market basket update of 3.4%, minus...CMS Rules
The Centers for Medicare and Medicaid Services announced its proposed Hospice Wage Index and Payment Rate Update proposed rule for FY 2026.
The proposed reimbursement update will raise the base payment rate by 2.4%, lower than the 2025 increase of 2.9%. The increase represents $695 million rise in total hospital payments, Hospice News...CMS Rules
The skilled nursing industry was elated by the Centers for Medicare and Medicaid Services (CMS) proposed Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, which included a 2.8% pay bump for FY 2026 and some other breaks that could reduce SNF costs.
The rate hike falls far short of the 4.2% raise that SNFs...
Countless critics of pharmacy benefit managers (PBMs) have raised the alarm about the sector's excessive profits, but despite the best efforts of lawmakers at all levels, they still operate relatively unchecked. This week, a bipartisan coalition of dozens of attorneys general submitted a letter to Congress urging them to pass a law...
To date, there is no set plan to cut Medicaid yet industry stakeholders and political analysts continue to speculate on the potential targets and magnitude of potential funding changes for the program that now insures 79 million Americans or 24% of the U.S. population.
The Trump administration launched its radical overhaul of the...
Mehmet Oz, MD, the new administrator of the Centers for Medicare & Medicaid Services (CMS), laid out his vision on April 10 for the $1.7 trillion agency—the largest under the Department of Health and Human Services. He pledged alignment with President Trump’s “Make America Healthy Again” agenda and a focus on modernizing...
The waiver application aligns with Arizona legislation passed in 2015 that requires AHCCCS to request (annually) the federal agency's approval to institute a work requirement for all “able-bodied adults” receiving Medicaid services, place a lifetime limit of five years of Medicaid benefits on “able-bodied adults” and develop and...
During Wednesday's State Medicaid Advisory Committee (SMAC) quarterly meeting, the Arizona Health Care Cost Containment System announced it had submitted a waiver to enact work requirements for an estimated 190,000 Arizona Medicaid members.
In 2017 AHCCCS submitted a 1115 waiver for AHCCS Works which was approved by CMS in 2019. The...
Funding cuts from the Department of Health and Human Services (HHS) are already having consequences nationwide and across Arizona.
The temporary halt on the cancellation of $11 billion in public health funding will keep the $239 million allotted to Arizona in the state for now, but the threat has already cost some crucial jobs....Government
The "DOGE"-led restructuring of the Department of Health and Human Services (HHS) continues this week with multiple agencies reporting instructions to cut billions in contracts. But confusion reigns as court cases over firing procedure loom and critical public health laboratories are shuttered.
Both the Centers for Medicare and...
The Congressional Budget Office (CBO) has released a new report with some optimism for the Medicare trust fund, with new projections estimating that it could remain solvent for an additional 17 years beyond what the office anticipated last year.
The CBO's projections takes into account the federal budget including public debt, the...
This presentation from MedPAC provides all the basics on Medicare agents and brokers, including compensation for initial sales and renewals as well as agent incentives that lead agents to pitch one plan over another when working with Medicare beneficiaries seeking a Medicare Advantage or Medigap plan. In 2022, about one in three Medicare...
The authors of this report conclude that while emergency departments (EDs) provide significant value to a range of stakeholders, the increasing pressures they've faced over the past decade now threaten the sustainability of America's current emergency care system.
The report evaluates the current value of emergency care in the U.S.,...
The United States has now surpassed double the number of measles cases it saw in all of 2024 as the West Texas measles outbreak continues and claims more lives.
Indiana health officials announced a measles outbreak in the state Wednesday, with six cases that have no known links to outbreaks in other states. Associated Press reports...
Integrated Medical Services (IMS), one of Arizona's largest, independent multi-specialty practices, will now serve as the anchor practice for Privia Medical Group - Arizona; IMS will continue to be physician-owned and operated.
Privia Health is one of the largest physician enablement companies in the United States, operating in 15...
This week, the Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. announced plans to cut funding and end programs that support public health. For example, in Arizona, a $50 million block grant to Arizona Medicaid for substance use prevention, treatment and recovery was terminated.
These plans include major...
Two insurance marketers are being accused of defrauding the federal government in a new case filed by the U.S. Justice Department (DOJ).
The suit alleges that the marketers improperly signed up low-income healthcare customers in subsidized insurance plans on the Affordable Care Act (ACA) exchange, netting $161.9 million through the...
The private sector is tightening its belt with providers and payers laying off hundreds of workers.
Last month, UnitedHealthcare appeared poised to launch layoffs after setting a resignation quota and offering buyouts for certain employees in its benefits operations unit that manages customer service, claims and enrollment. Those...
On Monday, the Arizona Chamber Foundation released a new analysis that found proposed reductions to Medicaid funding could have severe impacts on Arizona's economy, including its healthcare system and workforce.
The Chamber report was prepared by Rounds Consulting Group, and found that the ripple effects of the funding cuts would...
Congress's intended cuts to the Medicaid program loom large over all federal policy this year. How the cuts will proceed has yet to be determined, but one of the forthcoming options is the limitation of state taxes on providers.
Some in favor of restricting provider taxes argue that states receive federal matching funds without...
One of the nation's top healthcare financial advisory firms, KaufmanHall provided a cheat sheet for health executives confounded by the numerous implications of pending or debated health policy changes on America's hospitals.
The handy visual guide is designed to help hospitals assess how proposed federal policy changes could affect...
Superior HealthPlan CEO Mark Sanders was dismissed hours after Texas Attorney General Ken Paxton opened an investigation into the insurer’s alleged surveillance of state lawmakers and others. The abrupt leadership change comes as parent company Centene faces mounting scrutiny, including a recent Wall Street Journal report that found it...
The Department of Health and Human Services is continuing its ongoing purge of federal workers, which is having major impacts on healthcare providers, payers and medical infrastructure across the country.
As many as 10,000 workers may be cut from the workforce, including some leadership positions, in positions ranging from...
CMS Rules
