Lawyers representing over 34,000 inmates, whom are challenging the quality of healthcare in Arizona's prisons, are looking for another $1.6 million from the state in additional litigations fees. Since filing the lawsuit in March of 2012, the...Arizona News
The Office of the Inspector General (OIG) recently discovered $5.7 billion in unreasonable and unnecessary payments to inpatient rehabilitation facilities (IRFs) after a sample audit. The review was prompted by Medicare spending of about $7 billion on IRF stays in 2013, leading the OIG to question the payment system.
The OIG sampled...Arizona News
In May, a final rule from the Centers for Medicare & Medicaid Services (CMS) opened the doors for Medicare Advantage (MA) insurers to offer long-term care benefits to members. About 7.5 percent of MA plan enrollees in 2019 may have access to in-home support services or extra benefits, according to CMS officials.
In a speech...Arizona News
The largest orthopedic practice in Arizona adds to its facility list a 6,500 square foot space hosting all orthopedic specialties in the Northeast Valley at 90th Street and Shea Blvd.
In addition to its practice locations, The CORE Institute has physical therapy locations, two spine centers and an orthopedic specialty hospital.
The insurer is seeking 90 full-time employees. Positions are available at its Humana Pharmacy operations center in Glendale; dispensing facility in Phoenix; and call center located in Tempe.
Humana is hiring for Inbound Customer Service Representatives, Utilization Management Administration Coordinators, Pharmacy Technician and...Arizona News
On Friday, September 28, The Centers for Medicare & Medicaid Services (CMS) announced that Medicare Advantage (MA) premiums will decrease by six percent, on average, in 2019. Additionally, plan choices and new benefits are expected to increase as MA enrollment reaches new highs.
According to a statement from CMS, more than 36...Arizona News
Democratic gubernatorial candidate David Garcia sat down with Maria Polletta, Arizona Republic reporter, on Thursday for a live interview to help Arizonans gain better insight on Garcia's policies and what his administration would look like if voted into office.
Running up against Republican incumbent Gov. Doug Ducey, the...
Solve.Care's blockchain technology and digital currency is adopted by a leading accountable care organization.
The Care.Wallet's physician app displays provider quality data and metrics while tracking overall performance and rewards earned. The application uses Care.Cards within the blockchain system which sync and provide real time...
The Sun City hospital was already expecting a $60.4 million new emergency room, but last week Banner Health's board of directors also approved construction of a new $46 million, six-story patient tower.
Banner Health and Sun Health Foundation are partnering to fund the construction of the new 40,000 square foot emergency department;...
Dr. Whelan now has oversight of Banner – University Medical Center Tucson, Banner – University Medical Center South, dozens of clinics, the Banner – University Medical Group physician practice plan in Tucson and more than 6,000 Banner Health employees in Southern Arizona.
In a press release, Banner touts Whelan's decades...Arizona News
A discussion with The Hertel Report Publisher Jim Hammond on the most important stories we covered the week ending September 28, 2018.
Click on the microphone below to listen to the conversation moderated by Veronica Graff, a contributor to The Hertel Report.
Tennessee is now the fourth state to introduce a work requirement proposal for Medicaid enrollees, joined by Alabama, Michigan, and Virginia who also posted their proposals this month.
The waiver would require enrollees to seek or maintain work in order to keep Medicaid benefits. The state's requirements will specifically focus on...Arizona News
The National Committee for Quality Assurance ranked over 1,000 health plans on measures of quality, member satisfaction and the committee's survey accreditation results. The ratings aim to highlight patient care outcomes and how patients feel toward those outcomes and the care they are receiving.
The highest performing plans...Arizona News
Arizona's Medicaid agency identified significant concerns regarding the data submitted by HCA as well as, "HCA's lack of attention to, and focus on," the audit, which was used to evaluate immunizations to members before age 2 in compliance with childhood immunization reporting requirements.
It's not the first time AHCCCS has penalized...Arizona News
An Avalere analysis of accountable care organizations (ACOs) found that ACOs in the Medicare Shared Savings Program (MSSP) accumulate more savings as their experience grows. ACOs in the program for four years or more accounted for nearly all of the $317 in savings reported in 2017.
As of 2018, over 10.5 million Medicare...Arizona News
The pharmaceutical companies on Capitol Hill rarely get the short-end of the stick, so it shouldn't come as a surprise that the industry is lobbying for a provision to block the increase of the percentage of drug costs they must cover under Medicare.
Lawmakers are now considering to add measures that would ease the burden of drug...Arizona News
The Arizona Alliance for Community Health Centers begin providing weekly talking points on the ACA marketplace.
With just $10 million for marketing and outreach available from the federal government for this year's open enrollment on HealthCare.gov (90 percent below the fed's 2017 investment) spreading the word locally and ensuring a...
The film by the legendary documentarian Ken Burns features interviews with patients including John McCain and the Dalai Lama.
From the PBS press release:
The two-hour documentary examines how the Mayo Clinic meets the changing demands of healthcare.
The film tells the story of William Worrall Mayo, an English immigrant who...
Members only September Newsletter from The Hertel Report.
Members click here to access the edition.
Non-members, see below for what you're missing.
ACOs Push Back on CMS Proposals to Remix MSSP
Arkansas' Medicaid Work Requirement Experiment
Putting Medicaid Expansion in the Hands of Voters
Filed on September 12, the lawsuit alleges the state hospital impeded the ACDL's ability to monitor the conditions of facilities housing individuals with mental illness, and investigate incidents of abuse and neglect in those facilities.
Under the Protection and Advocacy for Individuals with Mental Illness (PAIMI) Act, ACDL is...