A bipartisan group of lawmakers have introduced a bill in the U.S. House of Representatives that would correct some of the glaring issues around Medicare physician reimbursement and the rate-setting process.
Physician groups have complained for...
Copa Health of Mesa filed a civil lawsuit March 23 against former CEO Sharareh (Shar) Najafi-Piper, her husband Brian Piper and Roya Health, a startup created and operated by the Pipers that Copa Health claims competed with Copa Health. The non-profit alleges misuse of funds.
On January 22, Copa Health board members fired Najafi-Piper...
The Trump administration is now targeting three major medical schools for investigation into admissions practices related to diversity, equity and inclusion (DEI).
On Wednesday, the Justice Department informed Stanford University, the Ohio State University and the University of California, San Diego of the investigations and demanded...Arizona News
Prior authorization, or the insurance practice of requiring authorization prior to the delivery of care or dispensation of drugs, has been under fire for the consequences of restricting timely access to care. Now, payers will be required to post data on how often they deny requests, how quickly they process them and how often denials are...
The Arizona Department of Corrections, Rehabilitation and Reentry (ADCRR) has filed an appeal of a February ruling by a federal judge that placed the department's prison healthcare system under a receivership, but two of the plaintiffs in the long-running lawsuit have submitted dueling visions for the receiver's authority.
The two...
CMS is launching a new Healthcare Advisory Committee to provide non-binding recommendations on federal policy and program administration, with a focus on improving care delivery and system performance.
As promoted by the Health & Human Services and the Centers for Medicare & Medicaid Services (CMS), the committee will...
Arizona’s ACA Marketplace saw a sharp pullback in 2026, with 357,144 plan selections during open enrollment, down roughly 67,000. According to the federal March open enrollment (OEP) report, 23.1 million people selected or were automatically re-enrolled in marketplace coverage, down about 1.2 million, or roughly 5%, from the prior...
The bill would make the distribution of the abortifacient drug Mifepristone a Class 4 felony, which carries the penalty of 2.5 years in state prison.
According to the Daily Star, the bill expounds on a similar Texas law by adding the penalty of Class 1 misdemeanor for anyone who "orders, solicits, requests, receives or attempts to...
Rates of behavioral health conditions are on the rise among seniors, but older adults are less likely to receive treatment, due in part to restrictions against Medicare-covered patients by outpatient mental health and substance use treatment facilities.
Last week, the Assistant Secretary for Planning and Evaluations (ASPE) Office of...Arizona News
Nearly four months after CMS launched its Wasteful and Inappropriate Service Reduction, or WISeR, model, the Electronic Frontier Foundation filed a lawsuit March 25 seeking details on how the AI-enhanced prior authorization program works for Medicare fee-for-service beneficiaries. The model is now operating in Arizona and several other...National News
The future of the Advisory Committee on Immunization Practices (ACIP) remains uncertain following a judge's intervention against changes made by recent appointees to the panel. One of the panel's members took to social media to express his displeasure with the ruling and indicated that the Trump administration has plans to disband the...White Papers, E books, Reports and more
Last week, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a duo of issue briefs that illustrate the use of antipsychotic drugs in nursing homes through inappropriate diagnosis practices.
The first issue brief focuses on the use of the drugs as chemical restraints and the second follows up...Available To All
The proposition of Medicare Advantage as a program relies on the assumption that private insurance companies are better situated to control costs and deliver medical coverage than a sprawling government bureaucracy. After nearly a quarter of a century, the results remain unclear, with obvious advantages and disadvantages to both forms of...Arizona Comings & Goings
Banner Health has named Paula Shepherd senior vice president and chief operating officer of Banner Plans and Networks, which serves 1.2 million members across six states.
Shepherd, a 25-year healthcare operations veteran, assumed the role March 16 and will oversee efforts to align insurance operations with coordinated care delivery...CMS Rules
This week, the Centers for Medicare and Medicaid Services (CMS) announced a new payment model that aims to bolster comprehensive health coverage for children with complex medical and behavioral health needs. The Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model is a state-based model that will serve...Arizona News
This week Phoenix Children’s announced it's aligning its statewide primary care network, Phoenix Children’s Pediatrics, under Phoenix Children’s Medical Group, bringing primary care and specialty physicians under a single leadership structure.
As part of the change, Darcey Winterland, MD was named Division Chief of Phoenix...Arizona News
As state legislatures, including Arizona, debate the merits of banning gender transition healthcare services for minors, a federal judge in Oregon ruled that Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. overstepped when he made the declaration that providers of such services "do not meet professionally recognized...
Private equity’s (PE) expanding role in healthcare is drawing renewed scrutiny from policymakers, researchers and market observers, as activity accelerates across hospitals, nursing homes and behavioral health services. In the past decade, PE investors have bet $1 trillion on healthcare. Lawmakers responded this week by introducing...
Arizona is advancing a major overhaul of its Medicaid infrastructure, with new milestones in its AHCCCS MES modernization effort focused on data exchange and program integrity. AHCCCS also plans to roll out a new customer service system next month. The modernization effort is part of a broader initiative to replace legacy systems,...Arizona News
Earlier this month, the Government Accountability Office (GAO) published a report on market concentration of private dental and vision insurers by state. The House Energy committee requested the report to determine how availability affects consumer choice. In 2024, Arizona had 44 dental insurers with Delta Dental claiming the most market...
A Massachusetts judge on Monday temporarily blocked changes to federal vaccine policy made under HHS Secretary Robert F. Kennedy Jr., ruling that recent appointments to the CDC’s vaccine advisory committee are likely invalid under the Federal Advisory Committee Act.
Several medical organizations, including the American Academy of...
Last week, the Centers for Medicare and Medicaid Services released requests for applications (RFAs) for state Medicaid plans and Medicare Part D plans that would be interested in participating in the new Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) Model which focuses on lowering prices for GLP-1 drugs....
A surprising twist in the war in the Middle East is a cyberattack targeting a Michigan-based durable medical equipment manufacturer, calling into question the country's health information security amid a stark increase in cyberattacks against healthcare infrastructure.
Last week, Stryker, a medical and surgical equipment manufacturer,...
Last Thursday, Microsoft revealed its new medical- and health-based AI offering, Copilot Health. Copilot Health is a feature within the Copilot app that will allow patients to interface with a chatbot designed to dispense personalized healthcare advice based on patient medical records and health data.
Microsoft said at the unveiling...National News
The Medicaid and CHIP Payment and Access Commission (MACPAC) released its annual March Report to Congress on Medicaid and the State Children's Health Insurance Program (CHIP), which focuses on home and community-based services (HCBS) workers and transparency for behavioral healthcare, especially as coverage involves the youth population...
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