Collectively, UHC Community Plan and Arizona Complete Health Complete Care Plan will provide health care services to the approximately 26,000 members enrolled in the Arizona Long Term Care System (ALTCS) and who are elderly and/or living with a...Arizona News
Previously unregulated imaging chain SimonMed is now fully licensed by the Arizona Department of Health Services (ADHS) following an incident involving a prison inmate and her guard.
Inmate Lacey Windust and a prison guard escorting her for imaging were both stuck to an MRI machine at a SimonMed Imaging Center in Avondale last...Arizona News
Modern Healthcare published its annual list of the 100 Most Influential People in Healthcare, which honors individuals throughout healthcare who have been recognized for their influence and leadership within the industry.
Peter S. Fine, CEO of Banner Health was on the list for the 10th consecutive year, ranked 93rd. Fine joined Banner...National News
Bright Health Group has been ordered to liquidate by a Texas court, which will block the enforcement of risk-adjusted transfer payments in Texas that the company has defaulted on.
According to Fierce Healthcare, Bright agreed to a repayment agreement with the Centers for Medicare and Medicaid Services (CMS) for $89.6 million, or...
Hospice business is shifting in Arizona as Banner Health (Banner) has closed hospice services in Arizona and will now refer to nonprofit Hospice of the Valley. Also, Pennant will take over hospice services for Southwestern Palliative Care and Hospice (Southwestern).
Banner, Arizona's largest health system, will shift its 100 hospice...
After presidential presumptive nominee Donald Trump repeatedly expressed his disdain for the Affordable Care Act, his contender Florida Gov. Ron DeSantis declared on NBC's "Meet the Press" on Sunday he would offer an alternative healthcare proposal to 'supersede' Obamacare - Biden's expected response: lower drug prices and permanent...National News
A new study shows that accountable care organizations (ACOs) are falling short in delivering behavioral health care for Medicare beneficiaries with depression and anxiety disorders.
The study, published in Health Affairs, looked at data from the 2016-2019 Medicare Current Beneficiary Survey and isolated validated depression and...National News
A Direct Contracting Entity (DCE) before transitioning to the REACH ACO model, Clover Health's financial performance was worse than any other DCE, losing $30.4 million in 2021 and $51.7 million in 2022. The company said it is predicting quicker profits in its Medicare Advantage (MA) line of business.
On December 1, Clover Health...CMS Rules
This week, federal regulators issued an interim final rule that would take action against states that have not complied with the federal Medicaid eligibility rules or reporting requirements during the redetermination period.
The rule says that the Centers for Medicare and Medicaid Services (CMS) will require noncompliant states to...
Nationally, 7.3 million Marketplace plans have been selected during the open enrollment period (OEP), a gain of nearly 33% year-over-year (YOY) as enrollment continues through Dec. 15, 2023, for 2024 coverage.
Last year the Centers for Medicare and Medicaid Services (CMS) reported about 5.5 million people nationally and about 77,000...
CVS Health, the largest drugstore chain in the country, will move to a simpler model for setting the prices of prescription drugs.
The new payment model, CostVantage, was announced on Tuesday. According to AZCentral, the chain's 9,000 pharmacies will have a reimbursement rate that defines the cost of the drug using a "transparent...Arizona News
The Arizona Health Care Cost Containment System (AHCCCS) is asking the Centers for Medicare and Medicaid Services (CMS) to obtain approval to increase the income limit for KidsCare eligibility to 225% of the federal poverty level (FPL).
The request is expected in increase enrollment in KidsCare by about 10,000 and is in alignment with...Arizona News
Gene therapies, which treat diseases at the genetic level, are becoming increasingly popular for pharmaceutical manufacturers as the efficacy of directly working with the human genome shows promise for effective health outcomes. But as the U.S. Food and Drug Administration approves them for use in the U.S., these drugs carry a hefty...Arizona News
Representative Ruben Gallego (AZ-03) has signed on to support the "Rural Physician Workforce Production Act," which would lift Medicare reimbursement caps on rural hospitals and incentivize urban hospitals to send residents to train at rural locations.
In a press release, Rep. Gallego noted that more than 40% of rural Arizonans worry...
The data in this recently published chartbook illustrates where and how many MA plans are offering certain nonmedical supplemental benefits and which MA organizations offer the most plans with a given benefit in 2024.
The report doesn't assess the effectiveness or use of supplemental benefits, but provides useful information to...
It appears likely that Cigna and Humana, two of the country's largest insurers, are discussing a merger that some report could be finalized by the end of the year.
The first report of the potential deal came from the Wall Street Journal, which reported that the structure and terms of the deal were under wraps, but the deal does...
As the use of artificial or augmented intelligence (AI) becomes more widespread across healthcare, industry leaders are advocating for guardrails and guidance to alleviate the risks that come with the software.
On Tuesday, the American Medical Association (AMA) released new "principles for augmented intelligence," which expounds on...
After denying responsibility and refusing to settle, Banner Health faced a Maricopa County jury in court that returned a unanimous verdict and the largest medical malpractice award in the state's history.
The jury found the non-profit Arizona health system, its employees, and Dr. Laurie P. Erickson negligent in the labor and delivery...Arizona News
Arizona is one of several states expected to add a measure putting abortion access on the ballot in next year's election.
Governor Katie Hobbs threw her support behind the initiative this week by adding her signature to the petition for the measure to make it onto the ballot. The Arizona Abortion Access Act, brought by the Arizona for...National News
As plans on HealthCare.gov and state-based exchanges are selling fast and 2024 enrollment is on another record-breaking year, the Trump reiterated his opposition to the Affordable Care Act (ACA).
The former president and current Republican frontrunner relaunched his attack on the ACA on Saturday morning with a post on his social media...
UnitedHealth Group (UHG) is facing a class action lawsuit initiated by two families of deceased Medicare Advantage policyholders who say that the insurer's use of proprietary AI software developed by UGH subsidiary NaviHealth, denied coverage for post-acute care and left them with an untenable bill.
The family members filed suit in...
A new report by Syntellis and the American Hospital Association (AHA) could drive the fight between hospitals and Medicare Advantage providers to reach a head, as the analysis shows MA plans' claims denials are directly contributing to declines in cash reserves.
Claims denials increased 56% for the median hospital between January 2022...
Arizona's average C score also highlights shocking racial disparities in preterm birth and infant mortality rates.
According to the 2023 March of Dimes Report Card, Arizona scores a 9.8% preterm birthrate, edging dangerously close to the national 10.4 % (D+).
Although Arizona reported a slight decrease in preterm birth rates, 10%...
The Centers for Medicare and Medicaid Services (CMS) released the HHS Notice of Benefit and Payment Parameters for 2025 Proposed Rule Nov. 15 which includes changes in network adequacy standards, the addition of routine adult benefits, revision of certain drug benefit requirements as well as minor changes to the new standardized plan...
The sales report for week three of the open enrollment period (OEP) for shoppers seeking 2024 health insurance on HealthCare.gov and state-based exchanges is brisk beating last year's performance; HealthCare.gov selections have jumped 51% compared to the 2023 OEP and are up 33% on state-based exchanges.
In the context of Medicaid...
CMS Rules
