Arizona Medical Association Joins National Coalition on Critical Federal Health Policy Issue

November 6, 2025

ArMA Advocates Alongside Medical Association on Prior Authorization, Hospital Ownership Restrictions & Expiring Insurance Tax Credits

The Arizona Medical Association joined dozens of medical associations nationwide to address three critical federal healthcare issues impacting Arizona physicians and their patients. Through coordinated advocacy, organized medicine is pushing for action on the Centers for Medicare & Medicaid Services' prior authorization pilot program, restrictions on physician-owned hospitals, and expiring health insurance tax credits.


Challenging CMS Prior Authorization Expansion Under WISeR Model


Beginning January 1, CMS plans to launch a prior authorization pilot program under the WISeR model, expanding prior authorization from Medicare Advantage and commercial insurance into Traditional Medicare. Arizona is one of six states where the program will be implemented.

ArMA joined a coalition raising substantial concerns about this rushed rollout. The expansion threatens to amplify administrative burdens physicians already face, with research demonstrating that prior authorization delays care, contributes to treatment abandonment, and can lead to serious adverse patient outcomes.


Concerns About AI-Driven Decisions


The coalition specifically highlighted concerns about using artificial intelligence in authorization decisions without adequate governance. AI-driven denials could remove clinical judgment and inappropriately deny medically necessary care — decisions that belong with physicians, not algorithms.


Questions About Implementation


CMS is moving forward with this large-scale program without providing operational details, adequate transparency, or evidence demonstrating patient care improvement.


ArMA and other medical associations urge CMS to halt implementation and collaborate with stakeholders to create payment processes that safeguard the Medicare Trust Fund without compromising patient access.

Read the full WISeR coalition letter.


Removing Barriers to Physician-Owned Hospitals


Federal law currently prohibits new physician-owned hospitals and significantly limits expansion of existing facilities. As healthcare consolidation continues, many communities—particularly rural areas—face reduced care access. This issue resonates in Arizona, where rural communities confront hospital closures and service reductions.


Impact on Access and Competition


ArMA supports removing statutory restrictions that prevent physicians from establishing or expanding hospitals. These limitations reduce patient choice and prevent innovative care delivery models from emerging.

The restrictions disadvantage independent physician practices facing declining reimbursement rates and increasing regulatory requirements. Research shows that highly consolidated healthcare markets result in elevated costs and poorer patient outcomes.

The coalition supports bipartisan legislation (H.R. 4002) to eliminate these restrictions and enable physicians to open and expand hospitals, improving access in underserved areas.

Read the full physician-owned hospitals letter.


Preventing Coverage Crisis: Extending Premium Tax Credits


Enhanced premium tax credits helping over 24 million Americans afford health insurance expire at the end of 2025. Without congressional action to extend them, millions will lose coverage with significant healthcare consequences.


Projected Impact


Without extension, 24 million Americans face average premium increases of 75%, causing at least 4.2 million to lose coverage. For Arizona physicians, this means patients will postpone necessary care until conditions become more complex and expensive to treat.

Coverage loss will burden hospitals with uncompensated care costs and force facility closures, especially in underserved and rural communities already struggling with access. The ripple effects include millions of lost healthcare jobs and reduced care access for all Americans.

Medical associations join 82% of Americans urging Congress to extend tax credits before year-end to prevent coverage disruptions and maintain patient access to timely care.

Read the full tax credits letter.


ArMA's Advocacy Commitment


The Arizona Medical Association's participation in these national advocacy efforts demonstrates the organization's commitment to addressing federal policies affecting Arizona physicians and patients. By joining state and national medical associations in coordinated advocacy, ArMA amplifies Arizona's medical community voice on issues impacting practice sustainability, administrative efficiency, and patient care access.

Arizona physicians can stay informed about these advocacy efforts and access the full letters at AZmed.org/sign-on.

ADHS Issues Standing Orders for Flu, COVID-19 Vaccine Access

By Admin User • September 18, 2026
Statewide orders keep pharmacists and physicians authorized to vaccinate Arizonans amid uncertainty over the next ACIP meeting. Statewide Orders Cover the 2026-27 Flu & COVID Season The Arizona Department of Health Services has issued statewide standing orders supporting access to the 2026-27 influenza and COVID-19 vaccines approved by the U.S. Food and Drug Administration. Arizonans seeking a flu or COVID-19 vaccine should contact their physician or pharmacy to confirm availability. Why the Orders Were Issued Arizona pharmacists may administer vaccines recommended by the Advisory Committee on Immunization Practices, vaccines recommended by the Centers for Disease Control and Prevention for international travel, or vaccines authorized under a prescription, including a physician-issued public health standing order. With the timing of the next ACIP meeting uncertain, ADHS worked with the Arizona Board of Pharmacy to issue statewide standing orders for the flu and COVID-19 vaccines, which function as a prescription allowing pharmacists and physicians across Arizona to administer them to anyone who wants one. ADHS Medical Advisor Weighs In "Vaccines are one of the most important tools we have to protect our communities. The Influenza and COVID-19 vaccines have been proven safe and effective at preventing severe illness, hospitalization, and death. Vaccines help us limit the spread of disease, reduce pressure on our healthcare system and reduce costs," said Dr. Richard Carmona, ADHS public health medical advisor and the 17th U.S. Surgeon General. "We have issued these standing orders to ensure safe and timely access to the vaccines in alignment with scientific and evidence-based guidance." What Arizonans Should Know The standing orders do not require every pharmacy to offer vaccinations, and they do not guarantee insurance coverage for administration. Coverage and out-of-pocket costs vary by plan, so Arizonans should check with their insurance provider before scheduling an appointment. 

Arizona Asks Supreme Court to Halt Prison Health Care Takeover

By Admin User • September 18, 2026
State attorneys seek an emergency stay after lower courts reject bids to delay receivership of the prison health care system. State Makes a Last-Ditch Appeal Attorneys for the Arizona Department of Corrections, Rehabilitation and Reentry asked the U.S. Supreme Court this week to delay a court-ordered receivership of the state's prison health care system. The request comes after both a federal district court and the 9th U.S. Circuit Court of Appeals declined to pause the takeover. In the recent application, former U.S. Solicitor General Paul Clement, a representative of the department, argued that the state deserves more time to make its case before surrendering control of its operations, including oversight of its employees and health care budget. Roots of the Case The dispute began in 2012 when inmates sued the department, alleging the prison system's inadequate medical, mental health, and dental care amounted to cruel and unusual punishment under the Eighth Amendment. The case went through years of litigation and a failed settlement agreement. In 2023, U.S. District Judge Roslyn Silver ruled that the health care system was "grossly inadequate." The court ordered the prison healthcare system to comply with more than 150 "quality indicators," but according to court-appointed monitors, the department failed to comply with 131 of the measures. In light of this finding, Silver named Annette Chambers-Smith, former director of the Ohio Department of Rehabilitation and Correction, to take over as receiver effective Oct. 19. Arguments on Both Sides Clement argues receivership should be the last resort and that Silver moved to it too quickly. He asserts that the department has made measurable progress, including growing its health care staffing by more than 50%, expanding substance-use treatment access, and adopting a new care model. Corene Kendrick, deputy director of the American Civil Liberties Union National Prison Project, which represents the roughly 25,000 people incarcerated in Arizona prisons, called the department's request a "Hail Mary" and said Silver had given the department years of opportunities to comply before ordering receivership. What Happens Next The Supreme Court has not yet set a deadline for the plaintiffs to respond to the stay request. Separately, the 9th Circuit is now reviewing the merits of the receivership order itself. The department filed its opening brief on Sept. 15, and the plaintiffs' response is due Oct. 15. Information in this article was sourced from the Arizona Mirror .