A federally qualified health clinic (FQHC) reached out to the Department of Health and Human Services (HHS) Office of Inspector General (OIG), seeking approval for a Food Is Medicine-inspired experiment, to test a proposal to either give boxes of...News
As sales from the 340B Drug Pricing Program reach $100 billion, the Trump administration, Congress and pharmaceutical companies are moving quickly to modify the program and reduce flexibilities.
Total costs of prescription drugs purchased under the 340B discount drug program increased 22.8% year-over-year, according to new data from...Arizona News
Affordable Care Act enrollment numbers are out for the first time since the expiration of tax credit subsidies spiked premiums at the beginning of the year. Arizona ranked as one of the top states in coverage losses.
A new report from the Department of Health and Human Services (HHS) found that enrollment has fallen from 22.1 million...Arizona News
After a decade of failed attempts to destroy the Affordable Care Act (ACA) through legal challenges, the Trump administration is changing its approach to applying heavy modifications that favor employers and boosting plans that aren't required to meet ACA criteria. This time, the administration is reaching out to states like Arizona for...National News
This week, the Department of Health and Human Services (HHS) announced that it will target fraud in the Medicaid and Medicare Advantage programs, and more MA insurers filed suit seeking to increase their star ratings bonuses.
The HHS Office of Inspector General announced it had generated $5.6 billion in "monetary impact" from...
The ACO Realizing Equity, Access and Community Health (ACO REACH) Model, which is set to sunset at the end of 2026, generated nearly $1 billion in net savings in 2024 according to a new report from the Centers for Medicare and Medicaid Services.
Last Friday, the agency released the performance results for the model and touted the year...
In May, America's hospitals saw higher net operating revenue and outpatient revenue compared with a year earlier, while inpatient volumes remained comparatively flat. Labor costs continued to rise, although workforce levels have largely stabilized. Drug, supply and purchased service expenses also remained above prior-year...Arizona News
Select Medical Corp. plans to close its 28-bed Select Specialty Hospital–Tucson East in September, eliminating 99 positions, according to a Worker Adjustment and Retraining Notification (WARN) filed with the state on July 9.
The long-term acute care hospital, located on the Tucson Medical Center campus, specializes in the treatment...National News
The Centers for Medicare & Medicaid Services (CMS) has proposed sweeping updates to the Medicare Physician Fee Schedule (PFS) that would expand accountable care organizations (ACOs), sunset traditional Merit-based Incentive Payment System (MIPS) in 2029 and further shift physician reimbursement toward value-based care.
The CMS...National News
Late last month, JAMA Network Open published a report on the effectiveness of the 2025-2026 COVID-19 vaccine after the paper was rejected for publication by the Center for Disease Control and Prevention's (CDC) Morbidity and Mortality Weekly Report (MMWR) by acting CDC Director and National Institutes of Health (NIH) Director Jay...
Last week, the U.S. Supreme Court ended its 2025-2026 session, a session that included several decisions that could impact the future of healthcare. The ruling on temporary protected status (TPS) for Haitians and Syrians is likely to have severe effects on the nationwide healthcare workforce and another ruling limits the scope of...
On July 1, the Centers for Medicare and Medicaid Services (CMS) issued proposed payment rules, including a provision that would substantially alter rates for the 340B drug discount program and implement site-neutral payments for certain imaging services beginning in 2027. The agency also proposed payment increases for Home Health Systems...Arizona News
Medicaid work requirements were included in the One Big Beautiful Bill Act of 2025 (OBBBA) as a means to offset the bill spending, meaning that the goal is for enrollees to lose coverage as a direct result of the program. In Arizona, up to 500,000 enrollees in the Arizona Health Care Cost Containment System (AHCCCS) will be...
Elevance Health is following the lead of other Medicare Advantage insurers by filing suit against the Centers for Medicare and Medicaid Services (CMS), alleging that they refused to allow the same star ratings boost given to Clover Health after a recent court ruling. Plaintiffs include Elevance's Medicare Advantage (MA) plan affiliate...
As Medicare Advantage (MA) enrollment surpasses Original Medicare, a new Milliman white paper argues that life sciences companies should no longer view the two programs as interchangeable when developing market access strategies for physician-administered Part B drugs.
Researchers found that each program creates markedly different...Arizona News
A new Urban Institute report finds Arizona women are more likely than the national average to report barriers to reproductive healthcare, with one in three saying they needed but did not receive at least one reproductive health service during the past year.
The survey of more than 2,700 Arizona women ages 18 to 49 found 33% reported...
Under the partnership, Banner Health will serve as the regional partner for Arizona and the non-profit health system's physicians and specialists will provide eligible Olympic and Paralympic Team USA athletes with access to sports medicine, orthopedics, primary care, women's health and other specialty services as part of the USOPC...
The Trump administration is proposing a sweeping rewrite of how Medicaid Section 1115 demonstration waivers are financed, replacing decades of negotiated budget neutrality policy with new statutory requirements that will require certification by the CMS Chief Actuary before new waivers, renewals or amendments can be approved. While...Arizona News
Over 450,000 Arizonans have lost access to the Supplemental Nutrition Assistance Program (SNAP) as the state was hit the hardest by rules implemented in accordance with the One Big Beautiful Bill Act of 2025 (OBBBA). Further, Arizona was also hit with a $208 million penalty for food stamp overpayments that exceed the acceptable...National News
Elevance Health paid the government over $342 million to settle allegations of overpayments by the Medicare Advantage program, marking the first time in the program's history that the Centers for Medicare and Medicaid Services (CMS) has successfully recouped as a result of audits for overbilling.
Medicare Advantage (MA) insurers are...Arizona News
Prior to the passage of the One Big Beautiful Bill Act of 2025, which authorized the creation of national rules for Medicaid work requirements, Arizona was primed to implement a work requirement for eligibility on its own. In the finalized rule, the Centers for Medicare and Medicaid Services suddenly altered the guidance for exemption...Arizona News
A new report says the No Surprises Act of 2020, which established consumer protections and billing rules for providers, isn't resulting in lower premiums as initially expected. But certain providers are netting a windfall through creative workarounds of the rule.
The Congressional Budget Office (CBO) can't say for sure if the No...
A broader vision for the future of home- and community-based services (HCBS) authorized under the Medicaid program is taking shape as the Trump administration expands its investigations into state-level programs and the U.S. Department of Justice (DOJ) issuing a memo undermining a landmark Supreme Court decision that provides critical...
The Medicare Payment Advisory Commission (MedPAC), in its June Report to Congress, concludes that Medicare Advantage's (MA) financial impact on hospitals and post-acute care providers is more nuanced than many stakeholders suggest.
The MedPAC Report to Congress - Medicare & the Health Care Delivery System - offers readers six full...
The Arizona Health Care Cost Control System (AHCCCS) the state's Medicaid agency, is rolling out a new analytics tool this summer designed to improve claims accuracy, strengthen program integrity and support providers through more efficient claims review.
The system, part of the agency's broader Alivia 360 platform, uses advanced...
CMS Rules
