A local and national leader on managed Medicaid and healthcare policy, Betlach spent nearly two decades with the Arizona Health Care Cost Containment System (AHCCCS), Arizona's Medicaid agency; Betlach served nine years as AHCCCS director and eight...National News
The minority staff of the U.S. Senate Committee on Finance released an unfavorable nursing home report last week titled, “Sheltering in Danger.” The report is an account of the way in which nursing home residents were put at risk during Hurricanes Harvey and Irma in 2017 due to poor emergency planning.
Senators claimed the...Arizona News
Last month, a global stock market sell-off sent the S&P 500 into dangerous waters, having analysts discussing potential bear market climates but stocks rallied this week and healthcare was leading the numbers following the midterm elections.
PricewaterhouseCoopers (PwC) released an analysis today regarding the effects midterm...Arizona News
New York-based startup health insurance company Oscar Health is expanding and hiring 400 new employees as it acquires new office space to establish a more robust presence in Arizona.
Oscar Health moved into its Tempe office in The Circuit complex just two years ago and is leasing another space in the complex, adding hundreds of...National News
According to a state audit released this past week, California’s Medicaid program, Medi-Cal, spent $4 billion between 2014 and 2017 on coverage for beneficiaries that may have been ineligible for Medicaid.
California’s $100B Medicaid program covers 13.1 million residents of the state (one-third of the state) and eligibility is...Arizona News
Anthem individual insurance plans bid goodbye to Affordable Care Act (ACA) markets across the nation to focus on the growth of its Medicare Advantage business, an experience more sweet than bitter; the insurance giant's third quarter profits were up 29 percent, year over year.
Enrollment in Anthem's insurance plans may have taken...National News
In the mid-term election, voters in Idaho, Nebraska and Utah voted to expand Medicaid eligibility to about 300,000; Montana voters rejected a new funding option for its expansion program.Medicaid expansion is now available in 37 states and the District of Columbia. Idaho's measure won by 22 points and is expected to extend Medicaid...National News
The U.S. District Court agreed with The Federal Trade Commission (FTC) request to temporarily shut down the operations of the South Florida company Simple Health Plans - a precursor to a permanent shut down.
Since October 2013, the health plan pitched consumers comprehensive health insurance or its equivalent - sometimes luring...National News
Published November 1, 2018, the rule updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019.
Physician payment rates are relatively flat with a 5-cent bump, year-over-year (YOY), but doctors will spend less time during visits...Arizona News
As the midterm elections are right around the corner, healthcare is on the minds of many; politicians and voters alike. The news cycle this week is marred with a slew of "he said, she said" pieces, Republicans pointing condemning fingers at the policies of Democrats and vice versa. The question is not "why healthcare", however, but "what...National News
The Trump administration approved Wisconsin's waiver request to impose Medicaid work requirements, marking the first "okay" granted for a state that has yet to expand its Medicaid eligibility.
The work requirement is based on achieving at least 80 hours a month working, in school, in job training or doing volunteer community...National News
The Office of the Inspector General's opined that when a Medicaid insurer provides financial incentives to network providers for increasing the number of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, such incentives would not violate the Anti-Kickback Statute.
In the proposed arrangement, network providers...National News
The proposed rule released Friday, October 26 would give 2020 MA plans the option of offering government funded telehealth benefits to all MA members regardless of their rural or urban zip code.
Also included in the pitch from The Centers for Medicare & Medicaid Services (CMS) is a plan to unify the appeals processes across...Arizona News
The Maricopa County Special Health Care District Board approved the bond sale in September. The bond's subsequent pricing and high investment grade ratings was received well by investors on October 11. The transaction closes October 30, 2018.
Maricopa County Special Health Care District board member Mark Dewane said MIHS’s...Arizona News
The Joint Commission identified the first and only designated Advanced Comprehensive Stroke Center in Arizona--Banner University Medical Center Phoenix (BUMCP) now holds two stroke certifications from the commission.
In 2003, a partnership originated between The Joint Commission and the American Heart Association (AHA) and together...Arizona News
Maricopa isn't the only county seeing more choice in the Affordable Care Act (ACA) exchanges this year; Pima County residents have their choice from three health plans, an abundance compared to last year's singular choice, Ambetter from Health Net.
Blue Cross Blue Shield of Arizona (BCBSAZ) along with Bright Health will be joining...Arizona News
Change Healthcare and ACO Partner reported a 26 percent lower 30-day readmission rate for participating providers and a 28 percent reduction in all cause readmission rates than a non-participant cohort in its first year. ACO partner is operated by Change Healthcare and Blue Cross Blue Shield of Arizona.
It is first complete plan...Data Resources
AHCCCS Complete Care (ACC) began October 1, 2018. The new integrated system allows managed care organizations to provide both physical and behavioral health services to better treat the needs of 1.6 million Arizona Medicaid members.
A quick read of the insurers, their October membership totals and overall membership losses with...National News
The bill includes support for research to find new, non-addictive pain relieving drugs and expanding access to substance abuse treatment for Medicaid patients.
According to CNN, the White House on Wednesday also announced public-private partnerships with Amazon, Belden Industries, Blue Cross Blue Shield, Cigna, CVS Health, Dispose...Arizona News
Hundreds of nurses at St. Joseph's and St. Mary's hospital in Tucson voted to unionize and join the largest registered nurses' union in the country--the National Nurses Organizing Committee (NNOC).
The votes were cast via secret ballot and officials from Carondelet Health Network, owner of the hospitals, told the Arizona Daily Star...National News
A proposal to lift a prohibition on allowing companies to take advantage of health reimbursement arrangements (HRA) dating back to the Obama administration is slated to reshape employee-based healthcare.
Announced Tuesday, the expansion of HRAs would enable employers to use them to pay for health insurance premiums, allowing...National News
The America's Physician Group (APG) recently launched a new initiative aimed at developing advanced alternative payment models (APMs). Dubbed "the Risk Evaluation Task Force," its inception was a result of a learning collaborative looking to move volume to value.
There is no lack of interest in APMs in the physician world, but...National News
On Monday, the Centers for Medicare and Medicaid Services (CMS) along with the Department of the Treasury released revised guidance giving states more regulatory power with innovation waivers under the Affordable Care Act (ACA).
The way CMS evaluates and accepts waivers regarding innovation for each state's individual market is...Arizona News
The personal information of approximately 75,000 people was breached last month after a government run healthcare sign-up system was hacked. The Centers for Medicare and Medicaid Services (CMS) announced the news on Friday, Oct. 19 just a few weeks before the Affordable Care Act exchange opens up for open enrollment.
CMS administrator...Arizona News
In 2019, after a 140-year tradition serving as Maricopa County's public teaching hospital and safety net healthcare system, Maricopa Integrated Health System will be known as Valleywise Health.
Although still under the oversight of the Maricopa County Special Health Care District Board of Directors and governed by the same mission,...
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The Hertel Report
