Mehmet Oz, MD, the new administrator of the Centers for Medicare & Medicaid Services (CMS), laid out his vision on April 10 for the $1.7 trillion agency—the largest under the Department of Health and Human Services. He pledged alignment with President Trump’s “Make America Healthy Again” agenda and a focus on modernizing...
The Centers for Medicare and Medicaid Services (CMS) issued a final Medicare Advantage technical rule that removes regulations for the use of artificial intelligence but maintains a Biden-era provision that restricts plans from modifying approved hospital decisions, and raises MA funding by 5%.
The rule also removed proposals for...
The Department of Health and Human Services is continuing its ongoing purge of federal workers, which is having major impacts on healthcare providers, payers and medical infrastructure across the country.
As many as 10,000 workers may be cut from the workforce, including some leadership positions, in positions ranging from...
The Trump administration has made clear that it intends to restrict enrollment in Affordable Care Act (ACA) plans, most recently with a rule proposed by the Centers for Medicare and Medicaid Services (CMS) that would implement a number of changes that are intended to lower plan costs.
However, some argue that the changes will make it...
The Centers for Medicare and Medicaid Services (CMS) has posted notice and a fact sheet for Quality Payment Program (QPP) exemptions notifying providers that the deadline for data submission has been pushed back from March 31 to April 14.
The extension does not apply to certain opt-in eligible groups or to Alternative Payment Model...
The Centers for Medicare and Medicaid Services (CMS) announced last week that it would cut four Medicare payment models, including Maryland Total Cost of Care, Primary Care First, ESRD Treatment Choices and Making Care Primary.
The models will end at the close of 2025, a year earlier than anticipated for all programs. According to...Arizona News
This week, the Trump administration continued its efforts to substantially cut funding and employment for federal agencies and programs, including departments that oversee, administer and fund healthcare services.
Early this week, the Department of Health and Human Services (HHS) increased its voluntary buyout offer in order to boost...CMS Rules
The federal government's assault on LGBTQ people and their access to healthcare services continued this week as the Trump administration ignores an injunction, the Supreme Court accepts a case on conversion therapy and researchers sue over the removal of articles from a government website.
Beginning on day one of his second term,...Arizona News
Last week, President Donald Trump issued an executive order aimed at the Departments of Health and Human Services (HHS), Treasury and Labor that would create an enforcement mechanism for the 2019 executive order on hospital price transparency.
The executive order modifies the demands of the original 2019 directive, including an...
In the midst of a flurry of executive orders and funding freezes impairing the administration of healthcare across the country, the Trump administration is signaling that it intends to make major personnel cuts in the Department of Health and Human Services (HHS).
Federally funded community health centers in at least 10 states are...
Elon Musk's "government efficiency" task force has fully infiltrated the critical information systems at the Centers for Medicare and Medicaid Services (CMS). The unsecured team could potentially compromise sensitive patient and payer information.
State officials and Congressional Democrats are moving to limit the legal scope of the...
Despite the efforts to dismantle any trace of the Biden administration elsewhere, the Trump administration intends to continue the Medicare drug price negotiation program, including the 15 drugs proposed for the second round of negotiations as one of President Joe Biden's last acts in office.
The Trump Centers for Medicare and...
The Centers for Medicare and Medicaid Services (CMS) launched its nursing home staffing campaign to support compliance with the nursing home staffing minimum rule. The support includes new websites designed to facilitate recruitment and education for new nurses.
The websites aren't a provision of the staffing mandate but an additional...
UnitedHealthcare has won its lawsuit against the Centers for Medicare and Medicaid Services (CMS) over its star ratings calculations for 2025. The agency must now recalculate its rating and immediately publish a revised score.
UnitedHealthcare (UHC) sued in September and petitioned for an expedited ruling so that revised ratings would...
The Centers for Medicare and Medicaid Services (CMS) has published new data from the 2025 Health Insurance Marketplace Open Enrollment Period (OEP). The OEP on HealthCare.gov runs from November 1 to January 15. The pace of enrollment is slower year-over-year.
Last year, 21.4 million signed up for health insurance through the ACA...
Humana's rough patch continues as it sues the U.S. Department of Health and Human Services over star ratings and revisits a potential merger with Cigna.
This month, Humana reached a $90 million settlement with the United States over allegations of fraudulent bids submitted to the Centers for Medicare and Medicaid Services (CMS) for...
Advances in artificial intelligence (AI) and other tech innovations continue to find applications throughout the medical industry, including in Arizona.
As more AI applications enter the biomedical industry, the Food and Drug Administration has investigated how it should go about regulating the programs, platforms and devices that use...
On Monday, the Biden administration announced a new proposed rule by the U.S. Department of Health and Human Services (HHS) together with the Labor Department (DOL) and the U.S. Department of Treasury, that would expand access to contraceptive products by making them free to all women of reproductive age with private health...
The Hertel Report compiled the Medicare Advantage Prescription Drug Plans competing in Arizona during this year's open enrollment period beginning October 15, 2024. Get all the highlights here; CMS published star ratings on October 10, 2024.
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The Government Accountability Office (GAO) wants the Centers for Medicare and Medicaid Services (CMS) to increase oversight and enforcement of its hospital price transparency rules, according to a new report.
The 2021 CMS hospital price transparency rule requires hospitals to post prices in machine readable format and make those files...
