This week, a Tucson man received 27 months behind bars and fined more than $100,000 for submitting false transportation records and a woman who faked cancer to get AHCCCS to pay for her abortion will get 10 years in prison.
In October 2017, the...Arizona Comings & Goings
Succeeding Greg Vigdor, who served the statewide association since 2013, Alameddin is a third-generation Arizonan and earned her Juris doctorate and health law certificate from Arizona State University before her work developing health policy impacting Arizona hospitals and patients.
Vigdor was well-known for helping pass Medicaid...National News
Designing benefits packages so that members pay less for high-value services and pay more for unnecessary, low-value services should result in lower overall costs and improved satisfaction. The VBID for Medicare Advantage has been expanded to all 50 states. Others are taking VBID to the exchanges. At the University of Michigan VBID...National News
The agency proposed the update on how it calculates the civil money penalties (CMP) assessed against Medicare Advantage plans for the 2019 contract year. CMS wants comments by April 15, 2019.
The CMP methodology is used by the Centers for Medicare and Medicaid Services to calculate penalties issued to Medicare Advantage organizations,...Arizona News
Former Hacienda Healthcare nurse accused of raping and impregnating an incapacitated 29-year-old patient has decided to fight court-ordered HIV and other STD testing. Nathan Sutherland's attorney argued on Tuesday that the tests would be a constitutional violation of his rights.
In January Sutherland, 36, was arrested for...Arizona News
Two studies highlight the role of health plans in driving up out-of-pocket prescription drug costs for 2019 individual Affordable Care Act (ACA) exchange enrollees, while insurers continue to file lawsuits against the federal government for unpaid cost-sharing reduction payments (CSRs).
Multiple insurers filed status reports in...Arizona News
Prescription drug spending and pricing data for 2017 was added to the Centers for Medicare and Medicaid Services' (CMS), updated drug dashboards to indicate spending per dosage of prescription drugs under Medicaid and Medicare Parts B and D. The data is tracked by changes in the average spending per dose.
In its first update since...Arizona News
The state's Court of Appeals ruled Tuesday that hospitals accepting Medicaid payments are not allowed to collect more payments by going after the money owed to a patient if the amount paid by the Arizona Health Care Cost Containment System (AHCCCS) is less than the final bill. A three-judge panel decided to void a section of Arizona law...Arizona News
The report from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute rated Yuma County No. 2, Greenlee County No.3 and Pima County No. 4; Apache County scored as the least healthy county in Arizona.
Medicare offers preventive services that can keep you healthy. Author Greg Dill, Medicare’s regional administrator for Arizona, California, Nevada, Hawaii and the Pacific Territories, spells out some of the preventive benefits offered through Medicare.
Read this informative piece from the Arizona Daily Star
You can always get...News
Cambia Health Solutions and Blue Cross and Blue Shield of North Carolina have formed a "strategic affiliation" to create a health insurer with 6 million enrollees and $16 billion in annual revenues.
Cambia Health Solutions, headquartered in Portland, Oregon operates BCBS branded plans in Oregon, Washington, Idaho and Utah.
BCBS of...Arizona News
A Green Valley-based hospital Santa Cruz Valley Regional (SCVRH) filed a counterclaim against Global Hospitalist Solutions, a physician staffing company that sued the facility claiming the hospital owes the doctors group over $1.9 million. The counterclaim states that the solutions company breached its contract and interfered with the...Arizona News
Last year, the three titans Amazon, Berkshire Hathaway and J.P. Morgan announced a healthcare venture to lower coverage costs and make health insurance more understandable for their employees. Last week a name for the mysterious partnership was revealed - Haven.
In a statement released on its website Mar. 6, CEO Atul Gawande said...Arizona News
The Phoenix long-term care facility is now being overseen by the state of Arizona, Hacienda is now under strict scrutiny of the Arizona Department of Health Services (DHS). Earlier this week, Hacienda grabbed the public's attention again with a shooting involving an off-duty officer and a man with a gun in the center's parking...Arizona News
Signed by Governor Doug Ducey on Monday the legislation extends the term of limited duration to one year, renewable for up to three years.
The legislation becomes law 90 days after close of the session. Currently, short-term, limited duration insurance (STLDI) in Arizona can remain in effect for no more than 185 days and can't be...Arizona News
The gift secures the philanthropist and best-selling author's Andrew Weil Center for Integrative Medicine, establishes two endowed chairs and an endowed fund for the program.
The integrative medicine pioneer previously gifted $5 million to the University of Arizona for integrative medicine education and research.
This gift marks the...Arizona News
The state's Medicaid agency, The Arizona Health Care Cost Containment System (AHCCCS,) said a programming error in January led to to its mailing of an IRS coverage statement to incorrect mailing addresses for thousands of AHCCCS members.
This week, AHCCCS members whose protected health information (PHI) was compromised due to the...Arizona News
Net losses shrink as member engagement rises for insurance start-up Oscar Health, according to its year end report released this month. And as telemedicine gains traction in the healthcare space, Oscar is not missing out with a new initiative offering members access to virtual care at anytime and anywhere through its Doctor on Call...News
This March issue paper by the American Academy of Actuaries gets detailed discussing a number of popular options for expanding the country's access to health insurance including the offer of a public option on the ACA marketplace, Medicare & Medicaid buy-in and Medicare for All.
The issue paper discusses major and design...Arizona News
Not long after last week's retirement party celebrating his tenure leading Arizona's Medicaid agency, Tom Betlach was named the newest member of the organization's Strategic Advisory Board.
Located in downtown Phoenix, Equality Health partners with health plans, and providers to improve health outcomes, transition to value-based care...Arizona News
Just this month a former head of sales for Phoenix-based Insys Therapeutics Alec Burlakoff, testified in a Boston federal court recounting directions he followed for years including: recruiting and bribing doctors to increase sales for Subsys. Burlakoff is the second to testify on the highly-addictive drug, following former CEO Michael...Arizona News
The Centers for Medicare and Medicaid Services (CMS) announced the release of updated hospital performance data on the Hospital Compare website and data.medicare.gov. The agency also announced on Feb. 28 that it would post potential changes to the star rating methodology for public comment and feedback in attempts to improve the way...National News
Reinsurance and cost sharing reductions (CSRs) are among the top recommendations to stabilize individual markets and lower premiums.
The New Democrat Coalition, a caucus of 101 centrists, wants to work with Republicans to bring down Affordable Care Act (ACA) premiums and reverse the impact of what they consider the Trump...Arizona News
Questions over patient care at Hacienda Healthcare loom as more than ten members of its management team, including the CEO, have resigned. The mass exodus of top officials followed the announcement that board chairman Tom Pomeroy would resign Friday, March 1st.
A 29-year-old woman in a vegetative state for over a decade gave...National News
A federal court this week ruled that United Behavioral Health (UBH) used unlawful, systematic claims denials for mental health and substance abuse treatment claims filed on behalf of beneficiaries across the nation.
On Tuesday, US Chief Magistrate Judge Joseph Spero found that to save money the insurer developed internal policies that...