Arizona’s AZRx prescription discount program has saved residents more than $1 million, or an average of $249 per prescription, according to a Wednesday press release from Gov. Katie Hobbs’ office.
The free card is available to all Arizona...
The Centers for Medicare and Medicaid Services (CMS) released star ratings for Medicare Advantage plans ahead of the 2027 annual enrollment period that begins today, October 15, 2026 and runs through December 7, 2026.
CMS publishes the MA (Medicare Part C) and Part D Star Ratings each year to measure the quality of health and...
Congress is considering a bipartisan overhaul of Medicare physician payments that would establish annual inflation-based updates, reduce quality-reporting burdens and provide new payment options for independent primary care practices.
The American Medical Association notes that the proposal comes as Medicare physician payments have...
Arizona will receive $166.99 million in the first year of a federal rural healthcare initiative (more than $30 million less than state officials requested) as rural providers prepare for Medicaid eligibility changes that could increase demand for uncompensated care.
The funding gap comes as Arizona's rural healthcare safety net...
The American Hospital Association and five co-plaintiffs have once again sued the federal government to block a second version of a 340B Drug Pricing Program rebate pilot, arguing that the policy could impose more than $1 billion in costs on hospitals and strain providers’ cash flow. The lawsuit marks the second challenge to the rebate...Arizona News
Humana is bringing in a new private equity partner to fuel the growth of its senior-focused primary care business, announcing a $2.8 billion transaction that will give BlackRock a majority stake in nearly 150 CenterWell Senior Primary Care clinics, 12 of those are in the Phoenix metropolitan area.
Humana announced the deal on Oct. 13...CMS Rules
Federal regulators have expanded their enforcement toolkit by granting the Centers for Medicare & Medicaid Services (CMS) authority to exclude providers and entities from Medicare and Medicaid, a significant shift that could expose Arizona healthcare organizations to heightened oversight and sanctions.
The new authority,...
The Treasury Department and IRS proposed regulations Wednesday that would tighten eligibility for Affordable Care Act subsidies and prevent people who lose Medicaid solely for failing work-reporting requirements from receiving federal assistance to purchase Marketplace coverage. The proposal implements premium tax credit provisions in...
A federal program that rewards hospitals for coordinating joint replacement care saved Medicare $180 million over three years without sacrificing quality, according to a new report. The findings are helping pave the way for a nationwide expansion of the model in 2028.
The results are especially significant for healthcare...National News
As part of the Trump administration’s broader effort to combat fraud, waste and abuse in federal healthcare programs, The Centers for Medicare and Medicaid Services (CMS) announced Wednesday that it had ended Affordable Care Act subsidies for 189,000 HealthCare.gov enrollees identified as having other public coverage or listed as...White Papers, E books, Reports and more
A new Milliman white paper examines what the Medicare GLP-1 Bridge program could mean for ACOs whose attributed beneficiaries qualify for the medications.
The temporary program, which runs from July 2026 through December 2027, provides certain anti-obesity medications to qualifying Medicare Advantage and traditional Medicare...Arizona News
Valleywise Health received two federal grants to expand behavioral health services for adults with opioid use disorder and young people showing early signs of psychosis.
A five-year, $3.75 million grant from the Substance Abuse and Mental Health Services Administration will support Valleywise’s MOSAIC program, which integrates...Available To All
A new review from the Medicaid and CHIP Payment and Access Commission (MACPAC) suggests that fragmented oversight, unclear accountability and disconnected data systems are creating challenges for Medicaid home- and community-based services (HCBS), potentially affecting providers, caregivers and beneficiaries who rely on self-directed...Available To All
Five states are urging federal officials to delay implementation of new Medicaid work requirements, citing mounting evidence that administrative hurdles, rather than a lack of work activity, are causing eligible beneficiaries to lose coverage.
In an Oct. 1 letter to the U.S. Department of Health and Human Services, the governors of:...White Papers, E books, Reports and more
Better Medicare Alliance (BMA) has released a 10-point policy roadmap urging Congress and the Centers for Medicare and Medicaid Services to strengthen Medicare Advantage oversight while providing greater stability for plans, providers and Medicare-eligible beneficiaries.
BMA is a nonprofit advocacy and research organization that...Arizona News
CommonSpirit Health is accelerating a sweeping cost-cutting and restructuring effort even as the nonprofit health system posted stronger patient volumes, revenue growth and operational improvements. The Chicago-based system operates in Arizona primarily under the Dignity Health brand.
CommonSpirit reported fiscal 2026 revenue of...National News
The Food and Drug Administration has approved the first pulmonary heart valve designed to be expanded after implantation as a child grows, potentially reducing the need for repeated open-heart surgeries.
The surgically implanted Autus Size-Adjustable Valve is approved for pediatric patients with congenital pulmonary valve disease. It...Arizona Comings & Goings
Phoenix Children’s has promoted four physicians from within its pediatric health system to lead pediatric critical care, cardiovascular intensive care, nephrology, and physical medicine and rehabilitation. The appointments include two physicians who earned medical degrees in Arizona and a third who completed her residency in Phoenix,...White Papers, E books, Reports and more
The analysis by Wakely Consulting Group, commissioned by America’s Health Insurance Plans, concludes that underlying healthcare costs and a less healthy risk pool, rather than higher administrative expenses or profit margins, have been the primary driver of recent ACA premium increases.
That national trend provides context for...
All 50 states met a Sept. 30 deadline to participate in the federal government’s GENEROUS MODEL designed by the CMS Innovation Center to test whether “most favored nation” pricing can reduce Medicaid prescription drug costs. The voluntary model is expected to save states $27.6 billion and the federal government $36.6 billion over...
The new Rural Health Transformation Program funding opportunities are designed to recruit and retain healthcare providers in rural communities.
The Arizona Office of Economic Opportunity released requests for grant applications for:
Provider Retention & Well-Being Microgrants, which will support efforts to reduce burnout,...
Arizona’s Medicare Advantage (MA) market will include 148 plans in 2027, up from 133 this year, while the average monthly plan premium falls from $4.47 to $2.81, according to CMS. Arizona has more than 1.56 million eligible Medicare beneficiaries, and all will have access to a $0-premium MA plan when annual enrollment opens Oct....
State Medicaid agencies already have extensive tools to address managed care plans that fail to meet quality, access, financial or contractual requirements. The bigger challenge may be ensuring states identify and address poor performance by using tools to measure whether interventions produce results.
A September Commonwealth Fund...
The Centers for Medicare & Medicaid Services (CMS) is launching a new initiative Investing in Health Outcomes with 37 states to shift Medicaid quality measurement away from process and paperwork and toward measurable improvements in patients' health.
Inside Health Policy reported that participating states are expected to focus on:...National News
UnitedHealthcare, Cigna Healthcare and Centene are joining CertifyOS, a new national provider credentialing model designed to reduce the repetitive administrative work physicians and health plans face when verifying provider credentials.
CertifyOS announced Sept. 23 that the three insurers, who are founding partners, will...
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