The American Medical Association (AMA) is urging federal regulators to expand protections for Medicare beneficiaries who want to leave Medicare Advantage and return to traditional Medicare, arguing that current rules leave some seniors without...National News
The Centers for Medicare & Medicaid Services (CMS) has unveiled a broad deregulatory proposal that would eliminate or revise dozens of Medicare and Medicaid requirements affecting hospitals, nursing homes, rural providers and other healthcare facilities, a move the agency says could save providers $320 million and return more than...Arizona News
Arizona will receive just over $165 million in second-year funding through the federal Rural Health Transformation Program (RHTP), part of a $50 billion initiative designed to strengthen healthcare access, workforce development and infrastructure in rural communities across the country.
The announcement comes after states spent...
The United States appears poised to lose its measles elimination status for the first time since 2000, marking a significant setback for public health officials as outbreaks continue to spread across multiple states, including transmission chains linked to Arizona.
An expert committee convened by the Pan American Health...
Medicare Advantage beneficiaries heading into the final weeks of open enrollment face a mix of good news and new challenges. Premiums are generally falling, plan choices are expanding, and supplemental benefits remain attractive. But experts warn that provider networks, out-of-pocket costs, plan closures and ongoing regulatory battles...
A new insurer-sponsored analysis warns that expanding Medigap switching rights could raise premiums, offering a counterargument to consumer protections unavailable in Arizona, where beneficiaries generally face medical underwriting after their initial enrollment period.
“Birthday rules” allow existing Medigap policyholders to...Arizona News
New Medicaid work requirements scheduled to take effect Jan. 1 are emerging as more than a coverage issue. Healthcare analysts, drug manufacturers, state officials and congressional Democrats are increasingly focused on what the policy could mean for patient access to medications and the broader healthcare system.
Under the 2025...Arizona News
Abrazo West Campus in Goodyear is investing $6.5 million to add 12 intensive-care beds, expanding access to advanced treatment for trauma, stroke, cardiac events, complex surgeries and other life-threatening conditions. The project continues Abrazo’s expansion in the West Valley.
The expanded ICU is expected to open in late November...Arizona News
The Phoenix-based nonprofit employs approximately 53,000 people in Arizona, making it the state’s largest private employer. Those operations account for nearly $12.9 billion in direct economic output, while Banner’s purchasing, supply chain and employee spending generate another $12.4 billion.
The analysis estimates Banner’s...National News
CVS Health plans to split itself into two publicly traded companies, unwinding one of the most influential healthcare mergers of the past decade and potentially reshaping relationships among insurers, pharmacies and pharmacy benefit managers nationwide.
The breakup is expected in the first half of 2028 and would separate CVS'...
Arizona residents shopping for Affordable Care Act (ACA) marketplace coverage this fall will find robust plan choice, but many could face significantly higher premiums in 2027 as insurers implement sizable rate increases and enhanced federal subsidies remain unavailable.
Open enrollment began Nov. 1 and runs through Jan. 15....
With less than two months before new Medicaid work requirements take effect Jan. 1, states are scrambling to build eligibility systems, hire staff and prepare beneficiaries, while federal regulators acknowledge implementation problems are likely and a recent court ruling reshapes a key exemption policy.
The work requirements,...Available To All
Just weeks before the Ambulatory Specialty Model (ASM) is scheduled to launch, some of the nation's largest healthcare organizations are urging federal officials to delay the mandatory Medicare program, warning that unresolved technical issues and financial risks could undermine both physician participation and patient access to...Available To All
Medicare payments to hospital outpatient departments and ambulatory surgery centers will increase 2.3% in 2027, while new site-neutral policies will reduce reimbursement for certain imaging services performed at off-campus hospital facilities, according to a new final payment rule released Wednesday, Nov. 4. The final rule impacts...CMS Rules
The rule also expands CMS’s authority to revoke provider enrollment and recover improper payments.
According to the Centers for Medicare and Medicaid Services, the increase includes a 2.1% payment update and a 0.3% increase associated with revisions to outlier payments. The agency is also continuing to recover what it considers...CMS Rules
The federal agency finalized a 2.31% reduction in Medicare’s 2027 physician conversion factor for most clinicians, exceeding the cut proposed in July, while increasing a key shared-savings rate and adding new ACO incentives.
Medicare physicians will face lower reimbursement beginning Jan. 1, but accountable care organizations (ACOs)...CMS Rules
The Centers for Medicare & Medicaid Services (CMS) has finalized a sweeping update to Medicare's dialysis payment system for 2027, increasing payments to dialysis providers, expanding support for home-based treatment and overhauling several quality measures that affect facilities treating patients with kidney...
Arizona’s Medicaid landscape is changing and healthcare leaders need to understand both the policy ahead and the performance behind it. The Hertel Report’s 2026 AHCCCS Data Edition brings together enrollment trends, plan financials and the latest quality results as Arizona prepares for federal work requirements and changes to...
Healthcare accounted for more than half of Arizona's job growth over the past year, helping offset losses in sectors ranging from hospitality to finance. But industry leaders warn that persistent workforce shortages could limit the industry's ability to keep pace with demand.
Arizona added 22,700 nonfarm jobs between September...
Millions of Medicare Advantage (MA) beneficiaries will face plan changes, benefit reductions or coverage disruptions in 2027 as insurers continue a multiyear effort to restore profitability amid rising medical costs and regulatory pressures.
Major insurers including UnitedHealthcare, Humana and Aetna are shrinking their MA...
The Department of Health and Human Services (HHS) unveiled a sweeping national strategy to overhaul kidney care, aiming to boost early detection, increase competition in the dialysis market and accelerate innovation in treatment and transplantation.
The plan was announced Tuesday by Health Secretary Robert F. Kennedy Jr. who...Arizona News
The Centers for Medicare & Medicaid Services (CMS) is proposing stricter verification requirements for consumers seeking financial assistance through Affordable Care Act marketplaces, a move the Trump administration says will reduce fraud and ensure taxpayer-funded subsidies go only to eligible enrollees.
Under the proposed...
A growing legal battle over Medicare Advantage quality scores is pitting major insurers against federal regulators, with Aetna and Centene joining a wave of lawsuits that could reshape how the Centers for Medicare & Medicaid Services calculates its influential Star Ratings. The disputes come as both companies report improving...
The senior author of the study, Jonathon Parker, M.D., Ph.D., a Mayo Clinic neurosurgeon in Arizona, reported demonstrated measurable changes in the brain within 18 minutes of deep brain stimulation (DBS) in people with drug-resistant epilepsy, a finding that could eventually help clinicians personalize treatment without waiting months...White Papers, E books, Reports and more
A three-part Georgetown University Center on Health Insurance Reforms series released this month uses states’ experiences with transparency, pricing reforms, and market oversight to propose federal strategies addressing healthcare ownership transparency, hospital fair-pricing reforms, and oversight of hospital and provider...
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