More than a million Arizonans enrolled in UnitedHealthcare's employer-sponsored, individual and Medicaid health plans will continue to have access to Phoenix Children’s facilities and employed physicians.
Phoenix Children’s Hospital's...
Centers for Medicare & Medicaid Services (CMS) announced Tuesday that insurance navigators who help Americans sign up for ACA plans will only receive $10 million for the 2019 open enrollment season.
This is the second cut in the last two years, down more than $26 million from the previous year. Navigators also took a cut last...
Arizona's Medicaid agency reported numerous case management issues against the former provider of Arizona Long Term Care Services (ALTCS).
After working as an ALTCS provider since 2006, Bridgeway lost its bid to secure a new contract with the Arizona Health Care Cost Containment System (AHCCCS) in March 2017 and was responsible for...
Social determinants of health (SDOH) define the conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes.
UnitedHealthcare Grant Recipients:
Association of Arizona Food Banks to increase access to fresh produce at local food banks statewide.
Brighter Way Institute...
The Health Services Advisory Group (HSAG) produced the June 2018 report for Arizona Medicaid's acute care and Comprehensive Medical and Dental Program (CMDP).
Overview of the CYE 2017 External Review included the following MCOs
Care1st Health Plan Arizona, Inc. (Care1st)
Health Choice Arizona (HCA)
Health Net Access (Health...Top of The Day
A California court ruling on Friday determined that Humana will not be able to dodge a Medicare Advantage Plan breach of contract suit from Prime Healthcare claiming inadequate reimbursements--underpayments.
Prime Healthcare was an in-network provider for Humana between August 2012 to February 2016, during which it claims Humana...Top of The Day
To crack down on Medicaid fraud and waste, The Centers for Medicare & Medicaid Services (CMS) will conduct audits of state programs and private Medicaid managed care plans as part of an initiative announced Tuesday, June 26.
CMS administrator Seema Verma attributed these plans to the agency's reformation of Medicaid for "a...Top of The Day
The Peoria pharmacists denied Nicole Arteaga her prescription for medication that would help manager her miscarriage and health, according to azcentral.
Recently learning that her pregnancy would result in a miscarriage, Arteaga made a decision to take medication to treat it rather than undergo an invasive surgical...Top of The Day
This week CMS sent a series of legislative suggestions to Congress including changing how it pays for Part D and how plans are marketed to those eligible for both Medicare and Medicaid.
The ideas were proposed to Congress in its June 18, Medicare-Medicaid Coordination Office Fiscal Year 2017 Report to Congress.
Last year, Dual...Top of The Day
The Centers for Medicare & Medicaid Services (CMS) recently released guidelines to ensure that states have the necessary tools to properly address a nationwide epidemic—the opioid crisis.
The guidelines include information on resources available to states and the different approaches available to combat the crisis; it also...Top of The Day
On Tuesday, U.S. Department of Labor (DOL) released a new rule focused on making healthcare more attainable for small businesses. The rule allows small businesses and those self-employed to shop for joint health insurance depending on location or industry.
This final rule regulating association health plans is supported by Trump...Top of The Day
This week, the AHCCCS Contractor Operations Manual (ACOM) and the AHCCCS Medical Policy Manual (AMPM) got a refresh.
Click here for the revisions and/or additions to the ACOM
and AHCCCS operations reporting guidelines including the Claims Dashboard Reporting Guide, Grievance System Reporting Guide and Provider Affiliation...Top of The Day
The 85-bed facility ranks among the worst in the country, receiving a one-star rating from the U.S. Department of Veteran Affairs.
Providing short-term rehabilitation and stabilization, the Prescott Community Living Center demonstrated a lack in quality of care with 45 percent of patients claiming to have moderate to severe...Top of The Day
The hospital's owner, New Vision Health, closes after creditors filed for involuntary Chapter 11 bankruptcy protection.
Court documents reveal creditors were owed about $13.1 million in unpaid loans and the hospitals' leases were terminated due to nonpayment. Reports say the bankruptcy receiver tried to secure capital to keep the...Top of The Day
Confirming its commitment to be the major hospital company in the east valley, Banner Health will build a new 120 bed facility adjacent to its existing Banner Health Center at Loop 202 San Tan Freeway and Alma School Road. Expecting an opening in the fall of 2020, Banner will spend more than $150 million on the project.
“We want...Top of The Day
In his dual role as senior VP at Change Healthcare and president and COO of ACO Partner, John Wallace spoke with HealthLeaders Media about the model, why it works, and how it will grow.
Learn more about ACO Partner in our June newsletter, but until then this interview will shed light on the value-based initiative that now includes...Top of The Day
The 20-states, including Arizona, are urging a federal district court in Texas to hold the Affordable Care Act’s (ACAs) individual mandate unconstitutional and to enjoin the entire law.
The brief, filed June 7 by the U.S. Department of Justice (DOJ), argues the individual mandate is unconstitutional and can't be extricated from...Top of The Day
The 2019 assessment at $287 million is $3 million less than the 2018 assessment.
For the contracting year October 1, 2018 through September 30, 2019 (CYE 2019), select AHCCCS-registered Arizona providers which meet agency established performance criteria will receive Differential Adjusted Payments (DAP).
AHCCCS will implement DAP...Top of The Day
For the second time, the state of Arizona is pushing to oust federal judge David Duncan from overseeing a legal settlement demanding that Arizona improves healthcare for its inmates.
The request to remove Duncan from the settlement stemmed from his threats to hold Corrections Director Charles Ryan and Assistant Corrections Director...Top of The Day
After nearly a decade with Cigna, most recently as the VP of operations and effectiveness for the insurer's Total Health & Network, Bennett will be responsible for leading strategy and operations to the 120 member group practice.
Bennett was also a leader in the information technology and service operations departments at Cigna...