The No Surprises Act, which intends to end the practice of surprise billing by banning most surprise bills from out-of-network providers went into effect on January 1. The rule will effect not only all emergency care billing and "most" nonemergency billing but will also require uninsured patients receive overviews of anticipated costs...
On December 14, there were 116,892 new cases of COVID-19 reported in the United States and the seven day case average is 120,719. On December 15, the nation added 1,285 new deaths and crossed the 800,000 mark for deaths related to the coronavirus. About 61% of Americans are fully vaccinated and two million doses are administered daily,...
Last Tuesday, providers gathered in Washington, D.C. to advocate against the Medicare direct contracting program, arguing that it could become the end of Medicare.
Members of Physicians for a national Health Program (PNHP), which supports a single-payer healthcare system brought petitions to appeal to U.S. Department of Health and...
On Wednesday, the U.S. Supreme Court heard oral arguments in the case Dobbs v. Jackson Women's Health Organization, which concerns a Mississippi law that bans abortion after 15 weeks of pregnancy. A ruling that upholds the law would directly challenge Roe v. Wade, the 1974 court ruling that legalized abortion in all 50...
Cases are on a slow uptick nationwide with new cases on Tuesday, November 23 totaling 92,785. The rolling seven-day average for new cases is 95,481. There were 1,474 new deaths nationally and the total number of deaths nationally is now over 775,000. About 70% of the country has received at least one dose of the vaccine and just under...Open
On Wednesday, November 10, the state of Arizona reported 3,794 new cases of COVID-19 and 39 new dates related to COVID-19. The figures came after four straight days of case counts over 3,000, but do not represent a downward trend. This brings the state total of deaths related to COVID-19 to 21,525. Nearly 60% of eligible individuals have...National News
After months of negotiations, the Build Back Better Act is taking form as a bill that appeases the concerns of most Congressional Democrats, including holdouts like Senators Kyrsten Sinema (D-AZ) and Joe Manchin (D-WV). The bill will now include a number of healthcare-related solutions and improvements to public health insurance programs...
On Wednesday, Arizona reported 2,180 new cases of COVID-19 and 124 deaths related to COVID-19. This brings the total of COVID-19 related deaths to 21,273. There were 20,976 vaccine doses administered in Arizona on Wednesday, including booster shots. 59% of the state is vaccinated. The number of intensive care unit beds in use also rose,...
On Tuesday, the Centers for Medicare and Medicaid Services issued a final rule for the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (PFS). The PFS includes policy changes for Medicare payments and Medicare Part B, and is the major mechanism for rate setting for the Medicare program as a whole. The PFS must remain budget...
Nationwide, community transmission of COVID-19 remains high and 77.8% of Americans over the age of 12 have received at least one dose of the COVID-19 vaccine. Over 190 million people have been fully vaccinated and 14.4 million have received a booster dose. In Arizona, over 8 million vaccine doses have been administered with 58.9% of...
Medicare Advantage is under pressure to demonstrate its cost-savings for the Medicare program following a report for the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) that suggests Medicare Advantage (MA) plans "may have inappropriately" leveraged chart reviews and health risk assessments to...
Cases of COVID-19 appear to be on the downward trend nationally, as the number of new cases on October 12 falls to 111,707. Last month at this time, the surge related to the Delta variant of COVID-19 was at its worst with a seven-day average of over 175,000 new cases per day. There were 1,938 new deaths related to the coronavirus on...
On October 5, there were 101,668 new cases of COVID-19 reported across the entire United States and 1,808 new deaths. At least 65% of Americans of all ages have received at least one dose of the COVID-19 vaccine and 56% are fully vaccinated. Transmission rates remain high nationwide, largely due to the spread of the more-contagious Delta...
This week, Congressional Democrats are sparring amongst themselves to bring President Joe Biden's infrastructure bill to a vote and the most public figure against the package as it stands now is Arizona's own Senator Kyrsten Sinema. What she wants is unclear, but what's in the balance includes closing a Medicaid loop hole and expansion...Arizona News
On Tuesday, the U.S. Department of Health and Human Services (HHS) announced an award of nearly $1 billion in funding for 1,300 health centers funded by the Health Resources and Services Administration (HRSA) Health Center Program.
The purpose of the funding is to supplement COVID-19-related capital needs, construction or renovation...
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) published a study on September 23 that found 20 Medicare Advantage companies generated a disproportionate share of federal overpayments by manipulating chart reviews and health risk assessments (HRA) to drive up reimbursement.
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The Biden administration announced last Friday that it would make available $25.5 billion in provider relief funding to offset revenue loss and higher expenses during the COVID-19 pandemic.
According to Fierce Healthcare, funding will be used for reimbursing smaller providers that generally operate on thin margins and to boost...
This week the number of children hospitalized with COVID-19 set a record with 1,900 pediatric cases in hospitals across the United States on Sunday night. The Delta variant's rapid spread is to blame, primarily among unvaccinated populations which include children under age 12.
Of all hospitalizations, children comprise just 2.4%...
The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) ran an audit on Aetna's Medicare Advantage (MA) business according to parent company CVS Health. The HHS OIG has cracked down on inaccurate adjustment scores submitted by MA plans including Humana and Anthem.
Aetna's MA reimbursement is...Arizona News
New data released by the Centers for Medicare and Medicaid Services (CMS) showed that more than 2.5 million people enrolled in health coverage on HealthCare.gov and state Marketplaces during the 2021 Special Enrollment Period (SEP), which will close on August 15th.
Enrollment increased by about 404,000 nationwide in July 2021....