In a motion filed in Maricopa County Superior Court, Sharareh Najafi-Piper, the former CEO of Mesa-based Copa Health, called claims of misuse of funds by her former company are “provably false” and argued the case should be handled through...CMS Rules
The Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway is designed to streamline communication from the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to manufacturers in the early stages of product development, allowing Medicare beneficiaries to participate in...Arizona News
The Arizona, mostly non-profit insurer, also suffered a $162.2 million loss in 2024, reversing a $85.4 million net income gain in 2023. In more bad news for the company, billions from an antitrust settlement will begin flowing to consumers across the country from Blue Cross Blue Shield and its member plans, including Blue Cross Blue...National News
The new standards are expected to be adopted by a group that includes Centene, Cigna, Humana, Aetna and UnitedHealthcare and will apply to orthopedic surgeries and imaging services like CTs and MRIs, in addition to other medical services that usually require prior authorization.
Modern Healthcare reports the standards will apply to...Available To All
Health insurers are holding their first quarterly calls with investors for 2026; UnitedHealthcare appears to be back on track after a rocky 2025, and Centene is reportedly holding steady despite losses from surging ACA premiums.
Centene's profits rose 17.5% to $1.5 billion in the first quarter with revenue increasing 7.1% to $49.9...
As the South Carolina measles outbreak comes to a close, the Arizona outbreak continues with the first confirmed community case of measles in Pinal County recorded this year. Nationally, improved detection methods are signaling that America's measles elimination status is on the rocks, propelled by increasing rates of vaccine...
Last year, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted to end the long-standing, 30-year recommendation for universal hepatitis B vaccination for all newborns within 24 hours of birth. Researchers then launched two studies, both published on Monday, on how ending the universal hepatitis B vaccine would affect...
The Utah Office of Artificial Intelligence Policy (OAIP) launched the pilot program with health technology company Doctronic early this year without the knowledge of the state's Medical Licensing Board. The goal of the program is for Doctronic's AI to automate routine, guideline-based prescription renewals to lighten the workload at...
Barr succeeds former board member Barbara Rodriguez Mundell and brings more than 30 years of leadership experience, including senior roles at Salt River Project and her current position as associate vice president and chief alliance officer at Arizona State University’s Global Futures Laboratory.
The Maricopa County Special Health...Arizona News
The total artificial heart is used as a bridge to transplant, supporting patients with end-stage heart failure while they wait for a donor organ. Arizona's largest health system has completed more than 50 of the procedures since 2022, positioning its program among the busiest worldwide and a key referral center for advanced heart failure...Arizona News
Nonpartisan advocacy group United States of Care is offering an olive branch to Congressional Republicans with a new "Red State Affordability Cohort," which will serve as a working group of six conservative-leaning states, including Arizona, for cross-state collaboration on policy and mutual support. Republicans have yet to coalesce...White Papers, E books, Reports and more
Late last year, uncertainty about the expiration of enhanced premium tax cut subsidies and changes to eligibility exacerbated market fears for ACA enrollment in 2026. Four months into the year, Wakely Consulting Group published a report forecasting reductions in enrollment and consequences for the risk pool as insurers develop their 2027...
Amazon is expanding into obesity care with a new GLP 1 management program through Amazon One Medical, integrating primary care, pharmacy and virtual services into a single offering.
The program is designed to address fragmented weight loss treatment by embedding GLP 1 prescribing and monitoring within a patient’s broader primary care...
In this April 2026 Milliman white paper, analysts report that rising costs in traditional Medicare are outpacing federal projections, creating new financial pressure for accountable care organizations whose benchmarks rely on those estimates.
The new analysis finds recent Medicare fee-for-service (FFS) cost trends have exceeded CMS...
Left with few places to cut federal spending, the Trump administration has set its sights on home- and community-based services, which officials accuse of being rife with "waste, fraud and abuse."
Home- and community-based services (HCBS) provide for the daily care and activity of elderly people or people with disabilities who are...National News
Medicare Advantage is entering a more contested phase, with federal scrutiny intensifying, insurers pulling back from markets and plans moving to stabilize provider relationships as payment policy shifts. That tension has direct implications in Arizona.
Meanwhile, this week, at a House Energy and Commerce Committee hearing April 21,...CMS Rules
As insurance companies raise flags about the cost of GLP-1 weight loss drugs in coordination with government payer programs, the Trump administration has rescinded its plan to have insurance companies fund coverage of the obesity drugs and will have Medicare pay the cost instead.
Last year, the White House announced a landmark deal...National News
As drug prices continue to rise and seniors struggle to keep up with inflated costs, a new Senate bill seeks to change the way Medicare Part D plans cover cheaper options.
Senators James Lankford (R-Okla.) and Maggie Hassan (D-N.H.) introduced the Ensuring Access to Lower-Cost Medicines for Seniors Act, which would require Part D...Arizona News
The City of Phoenix is considering an ordinance that would inhibit nonprofits and support services from providing food or medical care to homeless people in city parks. Advocates vociferously oppose the potential measure, stressing that unhoused people could die if they lose access to these critical services.
The draft ordinance under...News
As Arizona continues to align Medicaid and Medicare for dual-eligible members, new research is sharpening focus on how those integrated plans are paid. About 130,000 duals are enrolled in nine plans across the state, with UnitedHealthcare’s Dual Complete accounting for roughly half of that enrollment, according to April CMS...White Papers, E books, Reports and more
One in five American children has a chronic health condition, with even higher rates among those enrolled in Medicaid and the Children’s Health Insurance Program. The trend raises questions about how to address underlying systemic drivers and whether value-based care models can help improve outcomes for children and youth.
The...Arizona News
Under severe public scrutiny, health insurers have scaled back the use of prior authorization by 11% since 2024. Meanwhile, the new WISeR model faces struggles, but the Centers for Medicare and Medicaid Services (CMS) appears set on applying the practice to the Medicare program.
The Wasteful and Inappropriate Service Reduction Program...Arizona News
A bill in the Arizona State Legislature that would allow patients from across the state to be admitted to the Arizona State Hospital for psychiatric care regardless of their county of residence could still pass through the legislative process.
The bill, Senate Bill 1813, is sponsored by Senator David Gowan (R-Sierra Vista) and would...National News
The Trump administration is continuing its push towards electronic health record adoption and centralization through a new "Kill the Clipboard" initiative that pledges to streamline data sharing through biometric security and QR codes.
The "Kill the Clipboard" initiative is headed by Amy Gleason, a U.S. DOGE Service appointee and...National News
Last week, the Centers for Medicare and Medicaid Services (CMS) announced its proposal for the 2027 Inpatient Prospective Payment Systems (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System. The rules contain a proposed 2.4% rate increase for inpatient services and a nationwide test of an episode-based payment...
CMS Rules
