The Centers for Medicare and Medicaid Services (CMS) issued a notice to Elevance Health that it will no longer be allowed to enroll people in Medicare Advantage plans beginning March 31. The sanctions follow what CMS calls a "substantial and...White Papers, E books, Reports and more
A new analysis from the Medicare Payment Advisory Commission (MedPAC) suggests physician participation in Medicare Advantage (MA) remains widespread nationwide, even as network turnover and contracting dynamics continue to shape how beneficiaries experience access to care.
MedPAC’s review of the 2023 MA market found a large...Arizona News
Late last month, U.S. District Judge Rosalyn Silver ordered Arizona's prison healthcare system into receivership, transferring authority over all prison medical services to a court appointed official. The decision garnered criticism from Arizona Governor Katie Hobbs and others across the state for the unprecedented action.
Governor...National News
Early last month, President Donald Trump signed the Consolidated Appropriations Act of 2026, which included a provision to extend the waiver for hospital-at-home programs through September 2030.
Health systems are taking the opportunity to expand in-home acute care programs to attract a wider array of patients and include new services...Arizona News
The Department of Veterans Affairs has eliminated thousands of medical positions that were left vacant following resignations and retirements last year. The agency's cuts represent a smaller reduction than the Trump administration desires despite years of concerns with staffing shortages.
The cuts include 1,500 physician positions and...
For Arizona policymakers and Medicaid plans, the Office of Inspector General's Colorado findings highlight a growing tension between program oversight, the rapid expansion of private equity-backed applied behavior analysis (ABA) providers and the ability of families to access consistent therapy for children with autism.
The issue drew...
Despite the sweeping investigation that revealed a massive fraud scandal billing Arizona's Medicaid program, new investigations into behavioral health fraud and fake sober living homes targeting Indigenous communities continue to turn up illegal activity.
At the scandal's height in 2023, the number of ongoing investigations into...
A new RAND analysis of the Medicaid provisions in the One Big Beautiful Bill Act suggests Arizona could face some of the largest fiscal and enrollment impacts in the country over the next decade.
The research report published last week finds that expansion states with heavy use of state-directed payments and provider...
Last week, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) released a white paper on its recommendations for value-based care model alignment policies for nursing facilities and assisted living communities.
AHCA argues in the paper, titled "Advancing Accountable Care for Long Term Care...Arizona Comings & Goings
Warren Whitney was promoted to chief administrative officer for Valleywise Health, he was formerly the SVP of government affairs.Arizona Comings & Goings
Scott Trenter is now the vice president of sales at Curatus, a provider data management technology company. He was formerly the director of payor relations and contracting at Dominion Diagnostics.Arizona Comings & Goings
Chad Johnson is now providing oversight for Phoenix Children’s Medical Group administrative operations. He also serves as the the senior vice president of Phoenix Children’s Care Network.Arizona Comings & Goings
Virginia “Ginny” Rountree announced Feb. 2 that she would resign as director of AHCCCS, citing personal health concerns. Rountree had a short tenure, she was appointed October 6 and her final day was Feb. 13.
Roberta Harrison, a longtime Arizona Department of Economic Security official, now serves as interim AHCCCS...Arizona Comings & Goings
Jennifer Greening was promoted to the role of chief financial officer for Southwest Medical Imaging (SMIL). She was formerly a CPA within the organization....Arizona Comings & Goings
Jennifer Erickson is the new chief executive officer of Sonora Quest Laboratories. Erickson is taking over from David Dexter who is retiring next month after more than 26 years of leadership.
Erickson was formerly the chief financial officer and chief operating officer at Clin-Path Associates/Pathology Specialists of Arizona. She...White Papers, E books, Reports and more
Last Friday, the Congressional Budget Office published its projections on the Hospital Insurance Trust Fund (HI) financial position and found that the balance will be exhausted by 2040.
The CBO estimates that the balance will increase through 2031 but then spending will outpace income by 2032. The projection builds on CBO report...
Arizona has joined a coalition of states suing Robert F. Kennedy Jr. over changes to the federal childhood immunization schedule and the restructuring of the government’s vaccine advisory panel.
The lawsuit , which also names as plaintiffs Health & Human Services and Jayanta Bhattacharya from the Centers for Disease Control...
Medicare Advantage has hit a rough patch. Across the board, insurers are cutting plans in unprofitable markets, contracting benefits and now implementing new requirements in order to curb usage. The Centers for Medicare and Medicaid Services (CMS) is only adding to the market's trouble by issuing notice that rates will remain the same in...
The Centers for Disease Control and Prevention lost another recent leadership appointment this week when Deputy Secretary General Ralph Abraham abruptly resigned.
Abraham was appointed in December and served as second-in-command at the agency for just three months. According to NBC News, the reason cited was "unforseen family...National News
Released this week, the State Medicaid and CHIP Toolkit for Children's Behavioral Health Services and the Early Periodic Screening, Diagnostic and Treatment (EPSDT) Requirements was built in response to the 2022 Bipartisan Safer Communities Act which focused on states' implementation of EPSDT obligations.
The Georgetown University...Arizona News
Last Thursday, U.S. District Court Judge Roslyn Silver ordered the Arizona Department of Corrections, Rehabilitation and Reentry's (ADCRR) prison healthcare system into receivership following 14 years of protracted litigation.
The litigation has included two contempt findings, millions of dollars in fines and repeated violations of a...
The Republican-led Arizona legislature has sent a number of politically-loaded healthcare-related bills to Governor Katie Hobbs's desk so far this session, and may deliver more in the coming weeks.
Arizona Governor Katie Hobbs vetoed nine bills on Friday, one of which would have required hospitals that accept Medicaid to request...
The effort, branded the Comprehensive Regulations to Uncover Suspicious Healthcare initiative, or CRUSH, was introduced at the White House by Vice President J.D. Vance, Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz as part of a broader strategy aimed...Arizona News
This month, Madison Health Group announced it plans to acquire Magellan Health from Centene, roughly five years after Centene bought the company for $2.2 billion. The transaction, pending regulatory approval, would return Magellan to independent ownership under a private equity sponsor amid increased scrutiny of behavioral health...
Nearly 787,000 Arizona beneficiaries began 2026 enrolled in Medicare Advantage (MA), according to CMS January enrollment files — only a modest increase from roughly 780,058 enrollees in June 2025. The muted membership gain suggests growth may be slowing in a national and local market that this year remains flat at about 51%...
CMS Rules
