Reviewing national data from 2012 through 2023, a new ASPE issue brief examined rural hospital closures, finding that the strongest predictors of whether a rural hospital will close or convert to an outpatient-only facility were significantly low...National News
The U.S. Supreme Court (SCOTUS) shot down cases from AstraZeneca, Johnson & Johnson, Bristol Myers Squibb, Novo Nordisk, Novartis and Boehringer Ingelheim in a summary of orders issued Monday.
The court's summary declined to state why it refused to hear the cases, though STAT notes that the implication of the sweeping rejection is...National News
The Trump administration announced an expansion of the prescription drug discount platform, TrumpRx, through a partnership with Cost Plus Drug Company, Amazon Pharmacy, and GoodRx.
Until the partnerships were announced, the TrumpRx platform was widely criticized for offering access to discounts on brand-name drugs, though many were...Arizona News
On Monday, Arizona Governor Katie Hobbs announced that a new artificial intelligence tool would be deployed to target offenders in the state's largest fraud scandal. The scheme targeting AHCCCS/Medicaid has defrauded the state of at least $2.5 billion and preyed on predominantly Native American individuals battling addiction.
The...Arizona News
Medicaid quality measure reform is gaining momentum in the Trump administration as Centers for Medicare and Medicaid Services (CMS) leaders are raising questions about the abundance of metrics.
Center for Medicaid and CHIP Services Director Daniel Brillman said that the high volume of quality measures is burdensome for states and...
The Centers for Medicare & Medicaid Services did its annual April refresh of the agency's star ratings rankings for skilled nursing facilities. The Hertel Report compiled the rankings of Arizona's 141 nursing homes so our members don't have to parse the data.
Ratings Use a 5-star Scale to Summarize Quality Performance
5 Stars:...
Medicare Advantage enrollment continues to grow and now covers 51.8% of all Medicare-eligible beneficiaries, yet despite 301 insurers participating in the market, enrollment remains heavily concentrated among a small group of national carriers. Nearly 78% of MA beneficiaries are enrolled in plans operated by just 10 insurers, with...News
The Supreme Court has extended access to mifepristone, a widely-used and clinically-determined safe drug that is used to induce abortion. The order, issued by Justice Samuel Alito on Monday, holds back restrictions on the drug imposed by the Fifth Circuit Court of Appeals.
The case at hand was originally filed by the State of...Arizona News
With the Medicaid work requirement guidance deadline looming, the advisory panel that reports to Congress on Medicaid voted to recommend that the Centers for Medicare and Medicaid Services (CMS) should develop a plan for monitoring and evaluating Medicaid work requirements and how these policies affect eligibility, enrollment, spending,...National News
Industry leaders and health sector lobbies are lining up to support the Medicare Advantage Improvement Act (MAIA) of 2026, a bipartisan bill that addresses structural issues within Medicare Advantage.
The bill focuses on critical issues with billing and coverage like prior authorization, payment timing, and billing transparency. The...National News
Humana will move forward on cutting supplemental benefits offered in its Medicare Advantage in response to a lower-than-expected base payment increase in federal reimbursement and a difficult first quarter due to a lower 2026 Medicare Advantage Star Rating.
Earlier this month, the Centers for Medicare and Medicaid Services (CMS)...National Reports & Surveys
New analysis from Families USA shows that hospitals are charging commercial plans far more than what Medicare pays for services, highlighting the hospital industry's role in rising medical costs.
The four largest hospital systems in the country use their market dominance to overcharge customers relative to the Medicare rate, Families...National News
The Affordable Care Act health insurance exchange has taken a major hit in the first quarter of the year, according to earnings reports from large insurers, largely due to the expiration of enhanced premium subsidies that kept plans affordable for many enrollees.
In aggregate, health insurers expect enrollment will shrink by at least...CMS Rules
The Centers for Medicare & Medicaid Services is temporarily halting approvals of new hospice and home health agencies nationwide for six months, an unusually aggressive anti-fraud action that carries particular relevance in Arizona, one of the nation’s fastest-growing hospice markets in recent years.The six-month moratorium marks...National News
Aetna stabilized in the first quarter (Q1) of the year after a rocky 2025, bolstering parent company CVS Health's report. The improvement was directly related to the company's government-affiliated businesses, including Medicare Advantage (MA), Medicare Supplement plans and Medicaid managed care.
In a quarterly report released this...White Papers, E books, Reports and more
A new study published investigated federal oversight of Medicare Advantage (MA) plans and the scope of enforcement actions taken against insurers that violate federal standards. It found that enforcement actions were limited, raising concerns for regulatory effectiveness.
The study, published in JAMA Internal Medicine, was prompted by...
President Donald Trump has selected a new nominee for Surgeon General after pulling another after backlash to the another MAHA movement candidate.
President Trump initially nominated Casey Means, a wellness entrepreneur, physician and published author associated with the Make America Healthy Again (MAHA) movement that believes...
The Centers for Medicare and Medicaid Services (CMS) accidentally posted the Social Security data for 100 healthcare providers in the National Provider Directory.
The issue was initially noticed by the Washington Post, which reported that the publicly accessible database contained Social Security numbers linked to providers' names....
Late last week, the Fifth Circuit Court of Appeals reinstated a ban on abortion pills sent by mail in a ruling between the state of Louisiana and the U.S. Food and Drug Administration (FDA) over the safety of mifepristone and the accessibility of medication abortion by mail. The U.S. Supreme Court temporarily reversed the order on...
A new federal healthcare fraud task force will tackle Medicare and Medicaid fraud on the West Coast, including states like Arizona and Nevada, in addition to California.
The Centers for Medicare and Medicaid Services (CMS) has a new data analytics system that will be deployed with the "West Coast Health Care Fraud Strike Force" to...
Accountable care organizations (ACOs) are facing growing financial exposure from fraud and questionable billing outside their networks, as Medicare pushes participants to take on greater accountability for total cost of care, according to a new analysis from Milliman.
Under MSSP and ACO REACH, ACOs are responsible for all...
Federal spending on children continues to shrink as a share of the budget and the broader economy, even as total spending grows, according to a new Urban Institute analysis.
The year's annual report finds the federal government spent $533 billion on children in 2024, about 8% of total spending, a share projected to fall to 6% by 2035....
The initiative, housed within AHA’s Health Research and Educational Trust, will provide participating hospitals access to implementation support for the use of the West Health Accelerator, a digital hub of proven solutions, and peer learning networks designed to move technologies from pilot to systemwide adoption.
The new project...
In this report from Georgetown University, analysts reviewed five state employee health plans (SEHPs) facing the same significant increases as commercial healthcare costs: rising prices. As commercial healthcare costs rise and employer-sponsored insurance has grown increasingly unaffordable for employers and their employees, researchers...
The project expands the hospital from 204 to 238 beds and adds a new four-story patient care pavilion, along with additional operating rooms and upgraded surgical and patient spaces. Final elements are expected to be completed later this year, with a full opening planned in 2026.
The $170 million renovation and expansion at Deer...
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