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Connection Newsletter - Judge rules against HHS, surprise billing arbitration rule

The Departments of Health and Human Services, Labor and the Treasury said they would be taking steps to conform to the No Surprises Act court ruling.

Legislative update

Following crossover, it was relatively quiet at the Arizona Capitol this week. Each chamber began the process of hearing the opposite chamber’s bills, Senate bills in House committees, and vice versa. AzHHA supported bill SB1272 which extends AHCCCS coverage to 12 months postpartum from its current 60 days, advanced out of the House Health Committee Monday. Like other bills that contain an appropriation, passing out of both chambers is just the first step in the process. Any measure that has funding attached must also be included in the state budget, typically the last item addressed by the legislature before it adjourns for the year. HB2374, which allows paramedics to conduct the home visits in the hospital at home pilot program, advanced through the Senate Health Committee and will now head to the Senate floor for consideration.

The next major session deadline is for those crossover bills to be heard in committee in the opposite chamber—this must occur by Friday, March 25. For the first time in memory, the Senate censured a sitting member, Senator Wendy Rogers (R-LD6). Rodgers sits on the Senate Health and Human Services Committee. The censure doesn’t have a practical impact on Senator Rogers’ committee assignments or legislation she has sponsored.

AzHHA members from Benson Hospital and Yuma Regional Medical Center will be presenting in two weeks to the Arizona legislature Rural Caucus on the healthcare workforce needs in support of AzHHA priority, HB2691. This will be done in partnership with the community colleges that train the much-needed healthcare workers. We look forward to sharing the story of Arizona hospitals. Questions about the event may be emailed to AzHHA’s Director of Government Relations, Meghan McCabe.

Judge rules against HHS, surprise billing arbitration rule

A federal judge in Texas ruled in favor of the Texas Medical Association, on February 23, setting aside certain aspects of the federal independent resolution (IDR) process in the No Surprises Act. The Texas Medical Association argued that the Department of Health and Human Services’ regulatory interpretation didn’t align with the language in the No Surprises Act. Instead, it favored insurers by instructing the arbitrators to weigh the qualified payment amount (QPA), which is the median network rate calculated by the insurers more heavily than other factors. The Department of Justice will likely appeal the decision to the Fifth Circuit Court of Appeals. The Texas Medical Association’s lawsuit was one of at least six lawsuits that challenged the IDR process.   

In an announcement dated February 28, the Departments of Health and Human Services, Labor and the Treasury said they would be taking steps to conform to the No Surprises Act court ruling. This includes training certified independent dispute resolution entities and disputing parties on the revised guidance. The Departments also plan to open the portal for submitting payment disputes to IDR entities and permit parties to reopen the negotiation period for disputes if expired.

DOJ seeks to block United Health Group from acquiring Change Healthcare

A civil lawsuit to block United Health Group from acquiring Change Healthcare, a provider of health IT services, was filed on February 24 by the U.S. Department of Justice. The lawsuit alleges that if the deal were to go through, United Healthcare Group, the parent company of the largest health insurer in the U.S., would harm competition. 

In a press release from the U.S. Department of Justice, Antitrust Division Principal Deputy Assistant Attorney General Doha Mekki said, "the proposed transaction threatens an inflection point in the health care industry by giving United control of a critical data highway through which about half of all Americans' health insurance claims pass each year." He goes on to explain that "unless the deal is blocked, United stands to see and potentially use its health insurance rivals' competitively sensitive information for its own business purposes and control these competitors' access to innovations in vital health care technology. The department's lawsuit makes clear that we will not hesitate to challenge transactions that harm competition by placing so much control of data and innovation in the hands of a single firm."

ADHS approves moving into Tier 3 of the Antiviral Prioritization Criteria

With an increase in supply and availability of oral antivirals in the state, the Arizona Department of Health Services (ADHS) approved moving to Tier 3 of the Antiviral Prioritization Criteria. Under Tier 3 criteria, the use of the oral antivirals is expanded for use in all eligible patients within the general population. ADSHS will be sharing this information via its Health Alert Network. More information about antivirals may be found at

How to Reduce Hiring Risk in 2022 – Free webinar on background screening best practices and useful tips

Join AzHHA’s Affiliated Partner, Universal Background Screening, for a free webinar that will provide all the latest insights into critical employment screening issues and how to reduce hiring risk. Agenda topics include recent litigation and avoiding pitfalls; federal and state legislation; Equal Employment Opportunity Commission, Federal Trade Commission, Joint Commission, and Arizona regulatory updates; Ban the Box updates and other trends; and open Q&A. Register here for this complimentary virtual event to occur March 23 from 10 to 11 a.m.

COVID-19 supportive care

AzHHA’s Supportive Care program offers palliative care telehealth services to patients with acute or chronic COVID-19 symptoms and related complications at no cost to the patient. The service is open to people suffering from the complexities of COVID-19 related symptoms, or those chronic conditions exacerbated by COVID-19. Patients do not need a physician’s referral to receive this specialized, palliative care. Learn more at azhha.org/telehealth.

AzCHER Annual Conference – Collaboration, Coordination and Cooperation

Reserve your seat at our upcoming annual conference March 24, 2022, from 8:30 a.m. to 4 p.m. in Phoenix. The one-day conference theme is Collaboration, Coordination, and Cooperation. Our agenda features a range of topics including partner integration, healthcare workforce, supply chain integrity, resiliency and more. Attendees will hear from and directly interact with speakers from real-world events such as Colorado’s New Year wildfire. For more information and to register, visit our conference webpage here.

Upcoming Events

March 12 - Psychiatry for Non-Psychiatrists Conference

In response to the alarming rise in mental illnesses such as depression, anxiety, insomnia, addiction, and suicide – and the need for mental health providers – the University of Arizona College of Medicine Department of Psychiatry created a conference to train primary care physicians to more confidently care for their patients with these conditions. Learn more and register here.

March 15 - Introduction to POLST

Interested in learning how to use the Arizona POLST form with your patients? The one-hour Introduction to POLST workshop equips healthcare professionals with knowledge and resources to begin using POLST, Physician Orders for Life-Sustaining Treatment, in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. To register for the March 15 workshop, click here.

In the News

CMS reweighing MIPS data for physicians and extending deadline
Healthcare Finance

Pfizer-BioNTech vaccine effectiveness wanes for children 5 to 11, but still protects against serious outcomes, CDC data show
Washington Post

Senate GOP votes to strike Biden's vaccine rule for health care workers
The Hill