The Hertel Report

SCOTUS Blocks Restriction on Mifepristone by Mail - Justices Pause Ban for 1 Week to Consider Louisiana Case

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Arizona News

The New Federal West Coast Healthcare Strike Force Coming to Arizona

A new federal healthcare fraud task force will tackle Medicare and Medicaid fraud on the West Coast, including states like Arizona and Nevada, in addition to California. The Centers for Medicare and Medicaid Services (CMS) has a new data analytics system that will be deployed with the "West Coast Health Care Fraud Strike Force" to...

Milliman White Paper: Detecting External Fraud, Waste & Abuse in Accountable Care

Accountable care organizations (ACOs) are facing growing financial exposure from fraud and questionable billing outside their networks, as Medicare pushes participants to take on greater accountability for total cost of care, according to a new analysis from Milliman. Under MSSP and ACO REACH, ACOs are responsible for all...

Urban Institute Kids' Share Report Predicts Declining Federal Spend on Children

Federal spending on children continues to shrink as a share of the budget and the broader economy, even as total spending grows, according to a new Urban Institute analysis. The year's annual report finds the federal government spent $533 billion on children in 2024, about 8% of total spending, a share projected to fall to 6% by 2035....

News

AHA & West Health Launch $12M National Accelerator to Help Hospitals Operationalize AI, Virtual Care & EHR Improvements

The initiative, housed within AHA’s Health Research and Educational Trust, will provide participating hospitals access to implementation support for the use of the West Health Accelerator, a digital hub of proven solutions, and peer learning networks designed to move technologies from pilot to systemwide adoption. The new project...

Report: How 5 State Employee Health Plans Use Claims & Price Transparency Data to Improve Affordability

In this report from Georgetown University, analysts reviewed five state employee health plans (SEHPs) facing the same significant increases as commercial healthcare costs: rising prices. As commercial healthcare costs rise and employer-sponsored insurance has grown increasingly unaffordable for employers and their employees, researchers...

Arizona News

HonorHealth Nears Completion of $170M Deer Valley Modernization & Expansion Project

The project expands the hospital from 204 to 238 beds and adds a new four-story patient care pavilion, along with additional operating rooms and upgraded surgical and patient spaces. Final elements are expected to be completed later this year, with a full opening planned in 2026. The $170 million renovation and expansion at Deer...

Arizona Comings & Goings

Maricopa County Special Health Care District

Kelly Barr was appointed the Maricopa County Special Health Care District Board of Directors to fill the seat vacated by Barbara Rodriguez Mundell in March. Chris Koch was also named to a seat on the Valleywise Health governing board.

Arizona Comings & Goings

New Executive Roles at Phoenix Children's

Catherine Codispoti is now executive vice president and chief administrative officer at Phoenix Children's. Codispoti was formerly the executive vice president and chief people officer at Mercy.   Stephanie Kearney is now the senior vice president and chief strategy officer at Phoenix Children’s. Kearney was formerly the...

Former Copa Health CEO Disputes Lawsuit, Alleges Retaliation

In a motion filed in Maricopa County Superior Court, Sharareh Najafi-Piper, the former CEO of Mesa-based Copa Health, called claims of misuse of funds by her former company are “provably false” and argued the case should be handled through confidential arbitration, as required under her executive employment agreement. The filing asks...

CMS Rules

CMS & FDA Announces RAPID: A New Pathway to Expedite Access to Innovative Medical Devices for Medicare Beneficiaries

The Regulatory Alignment for Predictable and Immediate Device (RAPID) coverage pathway is designed to streamline communication from the Centers for Medicare and Medicaid Services (CMS) and the Food and Drug Administration (FDA) to manufacturers in the early stages of product development, allowing Medicare beneficiaries to participate in...

Blue Cross Blue Shield of Arizona Reports 2025 Net Loss of $335.2M - BCBS Prepares to Issue Consumers Payments From $2.6B Antitrust Settlement

The Arizona, mostly non-profit insurer, also suffered a $162.2 million loss in 2024, reversing a $85.4 million net income gain in 2023. In more bad news for the company, billions from an antitrust settlement will begin flowing to consumers across the country from Blue Cross Blue Shield and its member plans, including Blue Cross Blue...

National News

Consortium of Health Insurers Create New Prior Authorization Standards

The new standards are expected to be adopted by a group that includes Centene, Cigna, Humana, Aetna and UnitedHealthcare and will apply to orthopedic surgeries and imaging services like CTs and MRIs, in addition to other medical services that usually require prior authorization. Modern Healthcare reports the standards will apply to...

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Centene & UnitedHealth Group Report Healthy First Quarter Results

Health insurers are holding their first quarterly calls with investors for 2026; UnitedHealthcare appears to be back on track after a rocky 2025, and Centene is reportedly holding steady despite losses from surging ACA premiums. Centene's profits rose 17.5% to $1.5 billion in the first quarter with revenue increasing 7.1% to $49.9...

Research: University Studies Reveal Impact of New Hep B Vaccine Policy for Newborns

Last year, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted to end the long-standing, 30-year recommendation for universal hepatitis B vaccination for all newborns within 24 hours of birth. Researchers then launched two studies, both published on Monday, on how ending the universal hepatitis B vaccine would affect...

Arizona News

Valleywise Health Board Appoints Kelly Barr to Fill Vacancy

Barr succeeds former board member Barbara Rodriguez Mundell and brings more than 30 years of leadership experience, including senior roles at Salt River Project and her current position as associate vice president and chief alliance officer at Arizona State University’s Global Futures Laboratory. The Maricopa County Special Health...

Banner Health Now Global Leader in Total Artificial Heart Program

The total artificial heart is used as a bridge to transplant, supporting patients with end-stage heart failure while they wait for a donor organ. Arizona's largest health system has completed more than 50 of the procedures since 2022, positioning its program among the busiest worldwide and a key referral center for advanced heart failure...

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...

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...