Melanie MacEachern, Author at The Hertel Report

Melanie MacEachern

Freelance writer with skills and knowledge in healthcare policy, reproductive justice and art history. Skilled administrative assistant. Graduated from University of Michigan.

Author's Posts

Medical Board Calls for Immediate Suspension of Utah's AI Pharmacist Pilot - State Says 'No'

National News

Arizona News

Advocacy Group Recruits Arizona Policymakers into Working Group on Healthcare Affordability Campaign

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

Wakely White Paper: ACA Enrollment Report

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...

Arizona News

Home and Community Based Services (HCBS) Face Scrutiny From HHS

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...

CMS Rules

MA Plans Say No to Coverage of GLP-1s, CMS Pivots and Member and Medicare to Pay

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about the cost of GLP-1 weight loss drugs in coordination with government payer programs, the Trump administration has rescinded its plan to have insurance companies fund coverage of the obesity drugs and will have Medicare pay the cost instead.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

Bipartisan Bill to Lower Costs for Generic Drugs in Medicare Part D

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

Phoenix Mulls City Ordinance Restricting Medical Care in Parks

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...

White Papers, E books, Reports and more

ASPE Report Highlights Medicaid/CHIP Value-Based Care Gap in Pediatric Care

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

Market Update on Prior Authorization: Insurers Ease PA, Providers Blast New WISeR Model as CMS Expands Use in Medicare

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

ASH Reform: Legislation Would Expand Capacity By Lifting State Hospital Bed Cap

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

CMS Launches "Kill the Clipboard" Initiative to Digitize Patient Intake & Expand Data Sharing

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

CMS Proposes Payment Increase for IPPS & LTC Hospitals - CJR Episode of Care Model May Go Mandatory

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...

National News

CMS Pitches New Prior Authorization Rules for Pharmacy and Procedures

A new proposed rule from the Centers for Medicare and Medicaid Services (CMS) targets prior authorization (PA) of pharmacy benefits by shortening the turnaround deadline for certain requests and requiring the disclosure of denial rates. The regulation would require Medicaid and Children's Health Insurance Program (CHIP) insurers and...

CMS Rules

New MA Star Ratings Rule - CMS Estimates Changes Will Cost Taxpayers $18.6 billion

Last Thursday, the Centers for Medicare and Medicaid Services finalized a rule that overhauls the Star quality rating system for Medicare Advantage programs, cutting several measures, including the health equity index. The changes are anticipated to net insurers $18.6 billion over the next ten years. In lieu of the health equity...

National News

President Trump's 2027 Budget Proposal Cuts HHS Funding by 12% & Reduces Healthcare Workforce Programs by $1B

The Trump administration's 2027 budget proposal requests $111.1 billion in discretionary funding for the Department of Health and Human Services, slashing the department's budget in exchange for extended tax cuts and spending hikes for the military and immigration enforcement. The vision outlined in the budget proposal is one of high...

National News

131 Hospitals Sue HHS Over DSH Payments

A coalition of over 130 hospitals has filed suit against the U.S. Department of Health and Human Services over methodology used to calculate risk payments to hospitals that treat a higher number of Medicare patients. As it stands now, the Centers for Medicare and Medicaid Services estimates the number of low-income patients served by...

CMS Rules

CMS Proposes 2027 Payment Rules for SNF, Hospice, Inpatient Psychiatric & Rehabilitation Facilities

On April 2, the Centers for Medicare and Medicaid Services (CMS) proposed three of the four provider types, SNFs, hospices, and inpatient rehabs, are slated to receive a 2.4% pay increase, and inpatient psychiatric facilities are up for 2.3% in 2027. In the SNF proposed rule, CMS requested information for potential updates to the Patient...

Arizona News

Federal and State Nursing Home Oversight Update

The Centers for Medicare and Medicaid Services (CMS) published a series of revisions for survey procedures in hopes of streamlining procedure for surveys, enforcement and dispute resolution. The changes update Chapters 5 and 7 of the State Operations Manual (SOM) and consolidate oversight and investigations rules. The agency will now...

Available To All

Introduced: Bipartisan Provider Reimbursement Stability Act

A bipartisan group of lawmakers have introduced a bill in the U.S. House of Representatives that would correct some of the glaring issues around Medicare physician reimbursement and the rate-setting process. Physician groups have complained for years that certain aspects of the rate-setting process have undermined physicians' Medicare...

National News

Justice Department Targets Medical Schools For DEI Admissions

The Trump administration is now targeting three major medical schools for investigation into admissions practices related to diversity, equity and inclusion (DEI). On Wednesday, the Justice Department informed Stanford University, the Ohio State University and the University of California, San Diego of the investigations and demanded...

Page 6 of 92...4 567 8 ...