With the rise of the Omicron variant continuing the COVID-19 pandemic into the foreseeable future and the Build Back Better Act stalled in Congress, the landscape of healthcare in 2022 is somewhat uncertain. Two analyses, one from the U.S. Office of Public Policy and the other from the J.P. Morgan 2022 Healthcare Conference, lend some...
The Centers for Medicare and Medicaid Services (CMS) announced a new proposed rule that takes aim at prescription drug costs in Medicare Advantage (MA) and Medicare Part D plans. The agency said the rule would reduce out-of-pocket costs for beneficiaries and improve price transparency as well as "market competition in the Part D...National News
Following months of tense negotiations between moderate Congressional Democrats and the White House, Senator Joe Manchin (D-WV) ended any hopes for passing President Joe Biden's Build Back Better Bill on Sunday. This leaves many of the sorely needed healthcare spending and reform initiatives in limbo, although some Democrats hope to pass...Arizona News
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...
The Centers for Medicare and Medicaid Services (CMS) updated its guidance for nursing home visitations during the COVID-19 pandemic this week. Although the guidance relaxes previous regulations, the agency notes its concern for the vaccination rates of nursing home employees. Unfortunately, unlike most other areas of the medical...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...National News
Last week, the National Association of ACOs (NAACOS) sent a letter to the Centers for Medicare and Medicaid Services (CMS) requesting leniency regarding performance benchmarks and the potential option for accountable care organizations to select pre-pandemic years as the basis for benchmark measurements. Additionally, CMS announced the...National News
A bipartisan group of senators, including Senators Kyrsten Sinema (D-AZ) and Mark Kelly (D-AZ), sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure last Friday, warning against any potential cuts to the Medicare Advantage (MA) program. The letter comes as Democrats look for places to...
The Centers for Medicare and Medicaid Services (CMS) released its star ratings for Medicare Advantage Part C and Part D star ratings last Thursday, ahead of Medicare open enrollment, which begins October 15. Medicare Advantage (MA) plans get a star rating from one to five each year based on performance metrics including patient...
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...White Papers, E books, Reports and more
One of the greatest drivers of increases in drug spending comes in the form of launch prices for both new brand-name drugs and new generics. A new white paper from West Health, a non-profit that researches policy solutions for healthcare costs for seniors, and its Council for Informed Drug Spending Analysis (CIDSA), found that basing...National News
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...Arizona News
Spending per beneficiary is growing faster in Medicare Advantage (MA) and private plans than traditional Medicare and Part D prescription drug plans, according to the MedPAC analysis.
Modern Healthcare reports that the spending disparity has experts concerned, considering that Medicare Advantage enrollment is surging, currently...
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%...
Last week President Joe Biden called on U.S. lawmakers to enact legislation aimed at lowering drug prices, including allowing Medicare to negotiate drug prices and imposing penalties on drugmakers that hike prices faster than inflation.
Biden said that U.S. prescription drug costs were higher than any other nation in the world by two to...National Reports & Surveys
Medicare has continued to make overpayments for chronic care management services, and as a result, has cost the program and its beneficiaries millions of dollars in waste.
The Office of the Inspector General (OIG) examined over 7.8 million claims from physicians and 240,00 claims from hospitals for chronic care management services...Arizona News
As of Aug. 9, fee-for-service COVID-19 vaccine administration rates increased, according to AHCCCS.
For dates of service through March 14, 2021, AHCCCS adopted the Medicare payment rates as follows:
The AHCCCS fee-for-service rate for COVID-19 vaccine administration is $28.39 to administer single-dose vaccines.
For a COVID-19...Arizona News
Connie Health, a tech-enabled consumer Medicare navigation platform that assists people in making informed health and financial choices announced a $13 million Series A round and that it will begin operations in its second state; Texas.
The Series A comes just four months after the company began serving the public in Arizona and...Arizona News
Virtis Health, a national provider dedicated to therapeutic and diagnostic services for patients with complex conditions requiring specialty infusible and injectable medications, has announced the opening of three additional Ambulatory Infusion Centers (AICs) in Arizona. This expansion brings the total number of Virtis Health AICs in...
