Last week, the Department of Health and Human Services (HHS) agreed to end a pilot program for a 340B Drug Pricing Program rebate model. This week, the agency is reportedly exploring the possibility of launching another model with the same...News
Late last week, the White House announced the launch of TrumpRx.gov, a website that implements President Donald Trump's Most Favored Nation drug pricing policy to offer drugs to American consumers at lower prices.
As many as two-thirds of Americans report rising healthcare costs as a major financial concern, and the Trump...
As the measles outbreak continue to peak, public pressure is rising as the Trump administration stumbles to adequately respond.
Lsat year, cases reached a 34-year high and the spread is continuing at pace this year. NBC News reports that in the first full week of the new year, 279 new cases were reported and to date more than 700...
The brief suggests Medicare Advantage (MA) plans could be directed to be more precise about how they will serve people living with dementia through their models of care (MOCs). Authors recommend states require dual-eligible, special needs plans (D-SNPs) to meet the needs of their members with dementia and said government agencies could...National News
Three national insurers delivered earnings this week that, when taken together, sketch a market still adjusting to higher medical cost trends and shifting program economics.
Humana’s update centers squarely on Medicare Advantage (MA). The company reported fourth-quarter revenue of $32.5 billion and full-year revenue of $129.7...Arizona News
Brett Bingham is a nationally recognized Arizona healthcare executive who currently serves as the chief network development officer for Banner Plans & Networks and president of several Banner networks. He holds accountability for provider network strategy, growth, and performance across multiple lines of business and 35,000...
Flagstaff residents and seasonal summer visitors should not expect a new hospital anytime soon, according to an update this week from Northern Arizona Healthcare (NAH), which reaffirmed the region’s need for additional hospital capacity but said it cannot yet announce a site or construction timeline.
The update follows a difficult...
National recognition of Arizona-based physicians continues to underscore the state’s growing appeal as a destination for highly specialized clinical talent. Phoenix Children’s announced that Dannah Raz, MD, MPH, the pediatric health system's division chief of developmental and behavioral pediatrics, has been named to Modern...Arizona News
Virginia “Ginny” Rountree announced yesterday that she will resign as director of the Arizona Health Care Cost Containment System (AHCCCS), citing personal health concerns. Her final day with the agency will be Friday, Feb. 13.
After deep consideration and conversations with my family, I have made the difficult decision to step down...
The notion that a Republican administration would be inherently favorable to Medicare Advantage (MA) is being tested. From CMS’ decision to hold MA rates flat for next year, to the DOJ's continued enforcement actions related to MA billing and the OIG's heightened scrutiny of upcoding practices, MA stakeholders are preparing for a bumpy...
CommonSpirit Health is moving to end its revenue cycle management relationship with Conifer Health Solutions, a subsidiary of Tenet Healthcare. Instead, the nonprofit health system is breaking its contract to move the work in-house.
CommonsSpirit is the nation's largest nonprofit health system, known best locally by its subsidiary...Arizona News
As ICE efforts to deter illegal immigration increases in the US, legal immigrants and US citizens in mixed-status families are avoiding and even some are skipping health appointments as patients fear what might happen if they show up. Despite Federal law that forbids undocumented individuals from receiving coverage under the low-income...
On Tuesday, February 3, the House narrowly passed an appropriations minibus ending a three-day partial government shutdown that began on Saturday. The $1.2 trillion legislation addresses five spending bills and reauthorizes popular telehealth services, revises funding for Federally Qualified Health Centers, sets new PBM measures and...
The Rural Health Transformation Program (RHTP), which was initially proposed to offset rural health system losses due to Medicaid cuts, has become the centerpiece of the Trump administration's approach to innovating healthcare solutions on a geographic basis. A new report from Georgetown's Center on Health Insurance Reforms (CHIR) shows...
Not updated since 1999, the new guidance applies to all individuals and entities involved in the healthcare industry and serves as the Office of Inspector General's updated and centralized source of voluntary compliance program guidance for Medicare Advantage (MA). Entities and individuals can use the ICPG to help identify risks and...Arizona News
Arizona Complete Health, a subsidiary of Centene and one of Arizona’s largest AHCCCS insurers, has awarded $950,000 in capital grants to 32 nonprofit and public-sector organizations statewide.
According to the insurer, the grants are intended to strengthen community infrastructure supporting healthcare access, housing stability,...Arizona Comings & Goings
Arveson brings more than 25 years of healthcare finance experience to Banner Health. She was formerly the chief financial officer of the South Division of Providence, California's $9.3 billion non-profit Catholic integrated health system. At Providence, she served in various local operational and corporate roles, including chief...Arizona News
Northern Arizona Healthcare (NAH has received a $248,500 competitive grant from the American Cancer Society, supported by Pfizer, to improve cancer care coordination for Native American patients across northern Arizona and the Colorado Plateau.
The two-year initiative, known as Connected Care, focuses on patients receiving radiation...Arizona News
Arizona’s 2026 governor’s race is expanding beyond the two major parties, with a longtime healthcare executive stepping into an already competitive field as an independent candidate.
Hugh Lytle, founder and former CEO of Scottsdale-based Equality Health, announced this week that he is running for governor with the backing of the...National News
The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) was widely criticized for discussing revisions to the childhood immunization schedule. This week, the committee's new chairman, Kirk Milhoan, M.D., Ph.D. went on a podcast and appeared to suggest an openness to reviewing...CMS Rules
On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposal for the 2027 Medicare Advantage (MA) and Part D Advance Notice. The agency proposed a slight increase of 0.09%, shocking shares of publicly traded insurance companies.
The meager increase proposal comes after the Trump administration granted a generous...National News
Last Thursday, the United States formally withdrew from the World Health Organization in a move that many in the scientific community are calling "dangerous." Historically, the United States had been the most influential member of the 194-member organization and was its largest financial contributor.
The withdrawal was announced in a...National News
Six annual spending bills for the budget year need Senate approval this week, including an appropriations bill that would fund the Department of Health and Human Services through September. But following the murder of Alex Pretti by Customs and Border Patrol agents on Saturday, Democrats have vowed to oppose the bill without changes to...National News
Earlier this month, the Centers for Disease Control and Prevention (CDC) announced significant modifications to the childhood vaccine schedule, cutting the total number of recommended vaccinations from 17 to 11. On Monday, the American Academy of Pediatrics released its own immunization guidelines to recommend that children continue to...Arizona News
Arizona’s autism therapy network is under fresh strain this week after UnitedHealthcare began terminating contracts with Action Behavior Centers, prompting new concerns about access to care for children receiving Applied Behavior Analysis therapy under Medicaid managed care plans.
Parents told AZ Family they received notices that...
CMS Rules
