The health insurer covers about 13,000 Medicare lives across five counties in Arizona and earned a four-star rating in 2023 for its Medicare Advantage (MA) plans in the greater Phoenix area where Evernorth Care Group, the medical practice division...Arizona News
The United States alleged that the home health agency operator Bayada purchased two of Watermark’s properties in Arizona to induce referrals of Medicare beneficiaries. A former Bayada executive earned about $3.8M for blowing the whistle.
Based in Tucson, Watermark manages 79 senior retirement homes but the scheme was designed around...CMS Rules
Last Friday, the White House and the Centers for Medicare and Medicaid Services (CMS) released their long-awaited proposal for a federal minimum staffing mandate in nursing homes.
The proposal would require Medicare and Medicaid nursing homes to provide a baseline minimum 0.55 hours of care from a registered nurse per resident per day...
With nearly 50 organizations claiming ACO status in Arizona, the market for value-based payment arrangements is accelerating, Medicare is saving and ACO profits are growing within the Medicare Shared Savings Program (MSSP) and the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model.
In 2022...
Demand for mental healthcare is up across the country, especially in Arizona, but there aren't enough specialists to meet the population's needs.
One reason for the lack of access: providers are choosing to not accept health insurance due to low reimbursements, and insurance companies require high volumes of paperwork and often enjoin...Arizona News
For the first time ever, all ACOs operating in Arizona earned shared savings as participants in the Medicare Shared Savings Program (MSSP) in 2022.
Nationally, the MSSP saved Medicare $1.8 billion in 2022 compared to spending targets for the year. This marks the sixth consecutive year the program has generated overall savings and...News
Long-acting penicillin, a preferred treatment for syphilis in pregnant women and children, has been added to the list of drug shortages in the U.S. while Arizona currently faces the highest rate of syphilis in newborns. The ongoing drug shortage crisis highlights the limited powers of federal regulators.
In June, drug manufacturer...National News
A new class of highly popular diabetes drugs have changed the landscape for conventional wisdom on obesity and weight loss, but cost of the drug and weight stigma are preventing the drug from widespread authorization by insurers, including Medicare.
Ozempic and its sister drug Wegovy, produced by NovoNordisk, were the first of two...
It looks like the Biden administration will fall short on its promise to institute federal staffing minimums for nursing homes after a new study by the Centers for Medicare and Medicaid Services (CMS) commissioned to determine the appropriate level of staffing made no recommendations.
Instead, the study said, there were no staffing...
The Arizona Court of Appeals ruled voters will decide the rezoning of land near I-17 and I-40 on which Northern Arizona Healthcare is planning to construct a new hospital to replace the current Flagstaff Medical Center.
Northern Arizona Healthcare appealed an earlier court decision about the rezoning referendum arguing the...Arizona News
Under the program with evolvedMD, mental health services for Banner Health patients will soon be as close as one of Banner Health's Medical Group sites in metro Phoenix.
The partnership means evolvedMD will place a licensed behavioral therapist to work with a Banner Health patient's PCP to provide mental health expertise, psychiatric...
After reports of millions of children improperly dropped from Medicaid since redeterminations began last spring, the federal agency warned states August 30, 2023 of future federal action if their Medicaid and CHIP renewal requirements are out of compliance.
In a letter to all state Medicaid directors, the Centers for Medicare and...
States will now be required to report health quality measures for Medicaid beneficiaries including children's health, adult behavioral health and health home data to the Centers for Medicare and Medicaid Services (CMS).
The Core Set of Children's Health Care Quality Measures for Medicaid and the Children's Health Insurance Program...
House Bill 2691 sets up The Maricopa County Community College District (MCCCD) and Northland Pioneer College to receive $9 million in funds collectively from the American Rescue Plan to combat Arizona's behavioral health workforce shortages.
According to The Arizona Behavioral Health Workforce (AZBH), 40% of Arizonans live in...
On August 17, 2023, a cyber security breach at TMG Health put at risk 47,485 Blue Cross Blue Shield of Arizona patients' personal information, according to the U.S. Department of Health and Human Services.
On June 21, 2023, Arizona’s largest commercial insurer Blue Cross Blue Shield of Arizona (BCBSAZ) was informed by TMG Health, of...
On Monday August 21, 2023, National Fentanyl Awareness Day, Arizona's Governor Katie Hobbs and Senator Kyrsten Sinema made statements acknowledging the national opioid crisis and highlighting state and federal initiatives to curb overdose and deaths.
As Sen. Sinema notes in her press release, in Arizona more than five people die each...
Three new COVID variants are driving the rise in COVID-19 cases across the country, with hospitalizations from the virus reaching its highest levels since April. Public health officials are encouraging the public to take the updated bivalent COVID booster when it is released in the fall, in addition to the updated vaccine against...
Last week, the Fifth Circuit Court of Appeals in New Orleans issued a decision that restricts the use of mifepristone, a medication that is used in abortion. The U.S. Department of Justice, which is defending the Food and Drug Administration in the case, said that it would appeal the decision to the Supreme Court.
The three-judge...
Consumer advocacy group Families USA is coordinating the formation of a new coalition in support of hospital price transparency reforms and advocating for legislation that would strengthen federal oversight on transparency regulations.
The Centers for Medicare and Medicaid Services (CMS) moved to improve oversight for the Hospital...
The Centers for Medicare and Medicaid Services (CMS) is cracking down on hospices by adding new enforcement mechanisms and survey capabilities.
Earlier this month, the agency announced that four states, including Arizona, would be under strict scrutiny for the creation of new hospices after a wave of hospice businesses in the states...
Hospitals may be reporting difficulties with profit margins but the Mayo Clinic stands apart. For the second quarter of 2023, the Clinic reported a 10.4% year-over-year improvement in patient service revenue, boasting $3.54 billion for Q2 alone.
The Rochester, Minnesota based hospital also has locations in Phoenix and Scottsdale, as...
The event venue - the Sam Hill Warehouse - was built in 1903 and has rightfully earned a spot on the National Register of Historic Places. Hosts are kicking things off Sunday afternoon with a Prescott Scavenger Hunt History Tour and Networking Happy Hour -- with a day and a half of top-tier educational content beginning Monday...
Set to begin in 2025, the option to pay out-of-pocket costs for Part D drugs in monthly payments over a year was ratified in the Inflation Reduction Act (IRA).
CMS is releasing the guidance in two parts, this week the focus across 56 pages is on helping Medicare Part D plan sponsors and pharmacies prepare for the new program and...
Banner Health and software company, nference, are joining forces to incorporate the latest technology to better capture unstructured data in electronic medical records (EMR) to provide deep insights to advance discovery and development of diagnostics and therapeutics.
Banner Health's new partner uses the Federated Analytics...
The National Quality Forum (NQF) and The Joint Commission will no longer be competitors and become one force to focus on advancing key outcomes to benefit all stakeholders.
NQF will continue to focus on the widespread use of high impact, low burden measures that achieve affordable improvements in health, while the Joint Commission...
CMS Rules
