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

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.