Walmart is making another move into Medicare Advantage, partnering with fast-growing SCAN Health Plan to develop co-branded plans that could link insurance coverage with the retailer’s pharmacy, vision, food and over-the-counter services. The...Arizona News
The Centers for Medicare & Medicaid Services (CMS) provided a new roadmap for deciding which Medicaid beneficiaries are too medically impaired to meet 2027 work requirements. However, they leave much of the clinical and administrative decision-making to states.
Issued Sept. 8, CMS' guidance outlines an optional...Arizona News
Arizona is turning federal Rural Health Transformation Program (RHTP) funding toward telehealth hubs, a strategy that could expand access to care in communities where provider shortages and long travel distances remain persistent challenges.
A new Bipartisan Policy Center report identifies technology innovation and workforce...Arizona News
Arizona is set to receive $167 million in the first year of a five-year federal rural health program intended to transform care, but questions are emerging over whether the funding can address the financial pressures facing rural providers as Medicaid cuts take effect.
The program is also facing questions about transparency, according...
Subsidized ACA Marketplace coverage among Arizona young adults could fall 79% as enhanced federal subsidies expire and new restrictions take effect.
An analysis by Urban Institute projects that 1.8 million adults ages 19 to 24 would have subsidized Marketplace coverage in 2028 if the enhanced premium tax credits had remained in place....
Medicare’s ACCESS chronic-care model will add four new condition tracks next spring, doubling down on its effort to tie payments to patient outcomes rather than volume of care.
The Advancing Chronic Care with Effective, Scalable Solutions, or ACCESS, voluntary model is designed to give Medicare beneficiaries more options for managing...National News
Johnson & Johnson (J&J) is requiring health care providers participating in the federal 340B drug discount program to submit claims data for its medicines, adding new reporting requirements as drugmakers seek greater oversight of the program.
This week J&J announced it was requiring providers to submit claims data for each...
Before the 2027 Annual Enrollment Period (AEP) begins, Arizona healthcare leaders need a clear view of where the Medicare Advantage market has been—and where it appears to be heading. The Hertel Report’s 2026 Arizona Medicare Advantage Data Edition provides that foundation, tracking the enrollment, product and competitive shifts...
Phoenix Children’s has added two senior executives to lead its nursing workforce and its foundation's operations.
Tarra Kerr has been appointed senior vice president and chief nursing officer, overseeing strategy and operations for more than 2,100 nurses at the pediatric health system. Her responsibilities include workforce...
The American Medical Association released its 2027 Current Procedural Terminology (CPT) code set, with 453 editorial changes designed to reflect new medical technologies and evolving clinical practices. The update includes 299 new codes, 74 revisions and 80 deletions and takes effect Jan. 1.
One of the most significant changes...
The Centers for Medicare & Medicaid Services (CMS) is considering whether the three types of Medicare Advantage Special Needs Plans (SNPs) should remain separate or be streamlined, a move that could reshape how specialized coverage is offered to some of Medicare’s most vulnerable beneficiaries. Arizona MA SNP plans serve about...
A new study of Massachusetts' Medicaid ACOs offers a potential roadmap for improving maternal health. Set clear expectations, give healthcare organizations the resources to meet them and track patients beyond the traditional boundaries of pregnancy care.
The study, published in The Milbank Quarterly, examined how Massachusetts...Arizona News
Arizona is preparing for major changes to its Medicaid program that could affect more than 400,000 adults enrolled through the state's Medicaid expansion. The new rules go beyond work requirements. Beginning in 2027, affected Medicaid recipients will have to renew their eligibility every six months versus annually, creating additional...Government
CMS renamed ICHRA as CHOICE arrangements last week at an event in Indiana, claiming the model is an alternative to traditional employer-sponsored health insurance.
CMS Administrator Dr. Mehmet Oz pointed to Oscar Health as an example of a company supporting the emerging CHOICE framework, as reported by BenefitsPro.com. He...Arizona News
HHS awarded $383.4 million through the Substance Abuse and Mental Health Services Administration to strengthen behavioral health treatment, prevention and crisis response nationwide. Nearly two-thirds of the funding, $252 million, is directed toward the 988 Suicide & Crisis Lifeline, suicide prevention and mobile crisis...News
Work requirements could affect nearly 417,000 AHCCCS members statewide, and the new website will serve as the agency's primary public resource for explaining who may be subject to the requirements, who may qualify for an exemption and what members may need to do to maintain coverage.
The Arizona Health Care Cost Containment System...Arizona News
Navajo County Public Health will receive $549,905 annually under a five-year Rural Health Transformation Program (RHTP) grant designed to strengthen healthcare access, prevent chronic disease and build a more sustainable public health system in the county.
On Tuesday, the Navajo County Board of Supervisors unanimously approved a...National News
UnitedHealthcare (UHC) announced Tuesday that it will eliminate prior authorization requirements for approximately 1,700 medical procedure codes beginning Oct. 1, advancing its pledge to reduce the amount of care requiring approval by 30% by the end of 2026.
The changes apply to the insurer’s commercial, Medicare Advantage, Medicaid...
Arizona has become a national hot spot for disputes over out-of-network medical payments, raising questions about whether the federal system designed to resolve surprise billing disputes is adding to healthcare costs.
The federal independent dispute resolution (IDR) system was created under the No Surprises Act of 2022 to...
Arizona is preparing to impose new Medicaid work requirements on some adults, raising concerns that the state could face another difficult rollout of public-benefit reporting rules after recent changes to the Supplemental Nutrition Assistance Program.
Under the One Big Beautiful Bill Act of 2025 (OBBBA) beginning Jan. 1, 2027,...Arizona News
As physicians and lawmakers weigh whether private equity’s capital and promised efficiencies outweigh risks to cost, access and clinical autonomy, the closure of two investor-backed urology practices in Tucson provides a cautionary Arizona example.
The practices joined United Urology Group in 2021 as part of Arizona Urology...Arizona News
As Medicaid costs for autism therapy continue to increase, the Trump administration is attempting to address concerns about rising treatment costs. The feds are urging states to tighten their oversight of autism therapy providers to ensure therapies are based on medical need, not financial incentives.
In Washington, a...Arizona News
According to a new Issue Brief from Georgetown University, new Medicaid work-reporting requirements are likely to confuse low-income parents. Parents who qualify for AHCCCS under Arizona's caretaker relative category are not subject to impending 2027 Medicaid work-reporting requirements.
According to research from ...National News
New CMS guidance puts America’s Critical Access Hospitals (CAHs) on notice: Starting Sept. 20, their CAH status will automatically come under review when a newly certified acute-care hospital opens nearby—a trigger the agency calls “proximal ACH identification.” The guidance also extends routine CAH eligibility reviews from three...
Two unvaccinated residents of Pennsylvania have died following an infection with measles, marking the first deaths of the year attributable to the virus. Arizona now ranks among the lowest in the U.S. for kindergarten vaccination rates.
Only Idaho, Minnesota, Utah and Wisconsin have lower levels of the measles, mumps and rubella (MMR)...
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