In a new proposed rule, the Medicare Shared Savings Program redesigns the participation options for the majority of accountable care organizations (ACOs) to encourage a speedier transition to risk bearing tracks, currently Track 1 participants bear...Arizona News
In Arizona rate review filings, Cigna Healthcare of Arizona proposed an 18.2 percent on-average rate reduction for individual products it plans to offer in 2019.
The insurer returns to the Arizona market after offering individual/family exchange plans in 2014, 2015 and 2016. Cigna dropped out of the 2017 market, leaving only two...National News
The final rule issued August 2 updates Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS).
According to the Centers for Medicare and Medicaid (CMS), the rule is designed to empower patients through better access to...National News
On Aug. 3, the U.S. Department of Justice reached a settlement with Prime Healthcare and its CEO Dr. Prem Reddy have agreed to pay $65 million to settle allegations of Medicare over-billing for false claims across 14 Prime hospitals in California. A San Diego whistleblower Karin Berntsen, will receive $17.2 million for her reporting of...National News
A couple of Medicare Advantage (MA) policy changes implemented earlier this year point to MA insurers as the perfect candidates to pay for senior living services as part of new supplementary benefits.
Medicare Advantage allows government Medicare dollars to go through private insurers that in turn offer seniors benefit packages as...National News
Four major U.S. cities are suing President Trump and his administration for deliberately attempting to ensure the Affordable Care Act (ACA) fails, thus violating the president's constitutional duty to execute laws faithfully under the Take Care Clause.
Representing 4.5 million Americans, the plaintiffs, Baltimore, Chicago,...Arizona News
During this year's second quarter, Ensign Group said its strategies for underperforming skilled nursing facilities (SNFs), which included removing old leadership teams, pushed its SNF revenue to $286.3 million, an increase of 4 percent, year over year.
According to Ensign's CEO Christopher Christensen, the acquisition of SNFs in 2017...Arizona News
Douglas Luckett tells the Phoenix Business Journal that the hospital system will probably expand some existing facilities and could potentially add another Arizona hospital to the Boston-based Steward Health Care System, already one of the largest private systems in the nation. Steward purchased Iasis Healthcare in September...National News
Uncertainty surrounds potential mega-healthcare mergers as the CVS-Aetna deal and Cigna's acquisition of Express Scripts are in question. Just last year, the Justice Department thwarted the Cigna-Anthem and Aetna-Humana mergers.
The California Insurance Commissioner is adamant that the CVS-Aetna $69 billion merger proposal be blocked...Arizona News
The facility recently laid off 60 employees and announced a new CEO Kelly Adams, a partner in ER Hospital, a firm hired by the hospital's owner Lateral Investment Management.
In January 2018, the California-based equity firm Lateral Investment Management was the sole bidder on the hospital with its $28.5 million bid. Lateral is know...National News
HHS Secretary Alex Azar says current interpretations of the two privacy laws…are not just impeding value-based arrangements in healthcare. They can also get in the way of communities and families working together to combat our country’s crisis of opioid addiction, another top priority for President Trump.
Azar made the comments...National News
The Congressional Budget Office (CBO) missed $4 billion in savings evaluating changes to Medicare Part D by Congress.
Initially the Bipartisan Budget Act of 2018 had estimated saving Medicare $7.7 billion over the period of 10 years, but oversight from the CBO found that legislative changes to the drug discount program yielded...National News
On July 25, the House of Representatives passed a bill to loosen regulations for health savings accounts (HSAs), allowing spouses to contribute. The House also passed another bill letting more beneficiaries in on HSAs.
The Restoring Access to Medication and Modernizing Health Savings Accounts Act, HR6199, will grant plans...News
AzHHA releases financial information which includes improved overall operating income and continued stability in uncompensated care.The report focuses on the impact Medicaid expansion has had on lowering uncompensated care. Also included are stats about overall AHCCCS enrollment (falling), the hospital assessment and childless adults...National News
A federal report conducted by the Office of the Inspector General (OIG) on Tuesday revealed how some hospices take advantage of Medicare payments and in some cases, are negligent of patients.
Hospice services can play an essential role in ensuring the comfort of terminally ill patients. It is a popular Medicare benefit and...Arizona News
In the midst of a suit brought on by 12 Democratic attorney generals against the Trump administration, the President last week bragged about his new health plans and said they are already generating "record business."
Available to the public Sept. 1, the association health plans take a jab at the Affordable Care Act (ACA), which...Arizona News
Last week, members of the Arizona House and Senate voted on some major issues.
The following round-up of healthcare legislation recently proposed includes votes by Arizona's delegation to the House of Representatives:
Ban on “Junk Insurance” Health Plans or Short-Term Insurance
The House blocked a Democratic bid to...Arizona News
As healthcare accelerates faster toward the digital era, healthcare retailers and players are facing the ticking clock of innovation. Walgreens recently launched Find Care Now, a platform for its mobile and online users to find local and digital healthcare with numerous services offered.
Walgreens is currently working with 17 health...Arizona News
The new short-term, limited duration health insurance policies available during open enrollment cited as a cost driver for premium increases in the individual market.
On Wednesday, the Trump administration announced its final rule allowing the sale of health insurance policies exempt from the definition of individual health insurance...National News
Following last week's decision to reinstate dental and vision benefits to the state's Medicaid recipients, Gov. of Kentucky Matt Bevin's administration has made the call to suspend Medicaid copays priced from $1 to $50 by Aug. 1.
Many Medicaid healthcare providers are being kept in the dark as the agency makes sudden changes, but...National News
A sudden reversal of the Trump administration's decision to suspend risk adjustment payments just three weeks ago means the program paying billions to insurers in order to stabilize health insurance markets is back.
On Tuesday night, the Centers for Medicare & Medicaid Services (CMS) released a final rule that gave the...National News
Medicare Advantage plans have faced obstacles providing customized care for complex and seriously ill patients, but a recent report found it was primed to provide innovative ways to improve care for the seriously ill.
A report published by the Margolis Center for Health Policy at Duke University found "Medicare Advantage’s...Arizona News
According to the latest list from the Phoenix Business Journal, Banner Health, HonorHealth and Dignity Health Arizona rank in the top ten of all employers by number of employees.With over 36,000 full-time employees in Arizona, Banner Health and its $7.8 billion in revenue has long been the top health system in Arizona when it comes to...White Papers, E books, Reports and more
This analysis provides state-by-state estimates of the impact on insurance coverage, premiums, and mandate penalty revenues if the states were to adopt individual mandates. The work is based on the Urban Institute’s Health Insurance Policy Simulation Model, assuming each state adopts an individual mandate similar to the ACA’s
If...
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The Hertel Report
