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Drugmakers and hospitals continue to clash over the 340B program following the federal government's proposal of a new pilot model, which is scheduled to move forward in 2027 after undergoing revisions earlier this year. As outlined, the program would replace upfront drug discounts for hospitals with a post-sale rebate. Hospitals have fought vehemently against the model for more than a year, citing heavier administrative burdens and costs, and most recently filed another lawsuit requesting the program be blocked. Where the Program Stands After a long battle in the courts, the Health Resources and Services Administration revised its rebate program in mid-2026. The reworked model would require drug manufacturers to validate claims before paying out rebates, which would give HRSA more transparency into individual transactions. However, hospitals asserted that the agency's project cost analyses did not fully account for increased compliance costs and disruptions to cash flow. Opponents of the rebate model also stated that, ultimately, the program would undermine patient care if implemented. Despite negative feedback from stakeholders, the agency moved forward with plans for implementation. Drugmakers were given a deadline to submit their rebate plans, with approved plans being scheduled to take effect on January 1, 2027. Approved Participants & Covered Drugs After reviewing proposals submitted by drug manufacturers, HRSA authorized 10 to be part of the updated pilot program, including AbbVie, Pfizer, Merck, AstraZeneca, and Teva. A total of 21 pharmaceutical drugs are impacted, including Eliquis, Jardiance, Enbrel, Xtandi, Farxiga, Januvia, and Ibrance. How the Model Works According to Becker's Hospital Review , "covered entities will keep buying through their 340B wholesaler accounts at wholesale acquisition cost, then submit limited claims data within 45 days of dispense through a manufacturer-funded platform." The manufacturers then have ten days after receiving a complete rebate request to either pay or deny it. Denials related to eligibility, diversion, or concerns about duplicate discounts are not allowed. These concerns must be routed through a different audit channel. Hospitals, Others Respond The American Hospital Association and a coalition of safety-net hospitals filed another lawsuit in early October 2026 to block the revised pilot. The opponents estimate that the pilot will incur more than $1 billion in administrative costs for hospitals. The lawsuit was filed in the U.S. District Court for the District of Maine, which, notably, is the same court that ruled in favor of critics and blocked the first iteration of the rebate pilot program. Appellate courts previously settled the question of whether drugmakers can switch to a rebate program autonomously, ruling that they cannot do so without approval from the U.S. Department of Health and Human Services. Now, with 10 drugmakers approved for the rebate program by HHS, the question is whether the court will intervene once again. While the legal battle plays out, upfront 340B discounts remain intact. Source: Becker's Hospital Review, American Hospital Association

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Attorney General Kris Mayes Alleges ChatGPT's Design & Marketing Violates the Arizona Consumer Fraud Act

State Attorneys Denied Emergency Stay on Court-ordered Receivership of Prison Health Care System The U.S. Supreme Court on Thursday denied Arizona's last-ditch effort to temporarily halt a court-ordered takeover of health care operations and management within state-run prisons. Without an emergency stay of the court's order, Arizona's Department of Corrections, Rehabilitation and Re-entry must turn over the management of its health care operations for roughly 25,000 incarcerated people to Annette Chambers-Smith, former director of the Ohio Department of Rehabilitation and Correction, beginning on October 19. 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 mandated that health care in Arizona prisons would be overseen by Annette Chambers-Smith, former director of the Ohio Department of Rehabilitation and Correction, to take over as receiver effective Oct. 19. A Last-Ditch Appeal Attorneys for the Arizona Department of Corrections, Rehabilitation and Reentry asked the U.S. Supreme Court to delay a court-ordered receivership of the state's prison health care system. The request came after both a federal district court and the 9th U.S. Circuit Court of Appeals declined to pause the takeover. In the 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. Arguments on Both Sides Clement argues receivership should have been the last resort and that Silver moved to it too quickly. He asserted that the department 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 gave the department years of opportunities to comply before ordering receivership. What Happens Next Health care for thousands of incarcerated people will be managed under Chambers-Smith's oversight, as mandated by Silver, beginning on Oct. 19. The receivership affects all nine of Arizona's state-run prisons but will not impact health care for inmates in private facilities. Information in this article was sourced from the Arizona Mirror and Arizona's Family .

Eligible clinicians and group practices can request a targeted review of their final score before 2027 payment adjustments take effect. Final Scores Are Out, Adjustments Follow in About a Month The Centers for Medicare & Medicaid Services has released Merit-based Incentive Payment System performance feedback and final scores for the 2025 performance year. The 2025 final score determines the payment adjustment eligible clinicians and group practices will receive in 2027, and 2027 MIPS payment adjustments will be available in approximately one month. If an eligible clinician or group practice believes CMS calculated their final score or 2027 payment adjustment incorrectly, they must file a targeted review with CMS within 60 days. How the Targeted Review Window Works The targeted review window opened with the release of final scores and will close 30 days after the release of MIPS payment adjustments. CMS will announce the release of payment adjustments through the QPP listserv in approximately one month. CMS generally requires documentation to support a targeted review request, which varies by circumstance, and a CMS representative will contact applicants about any specific documentation required. If a targeted review request is approved and results in a scoring change, CMS will update the final score and, if applicable, the associated payment adjustment as soon as technically feasible. Common Reasons to File a Targeted Review Data were submitted under the wrong Tax Identification Number or National Provider Identifier. The clinician has Qualifying APM Participant status and shouldn't receive a MIPS payment adjustment. Performance categories weren't automatically reweighted despite qualifying for reweighting due to extreme and uncontrollable circumstances. How to Request a Targeted Review Sign in at qpp.cms.gov using HARP credentials, or ACO-MS credentials for Shared Savings Program ACOs — the same credentials used to submit 2025 MIPS data. Then click "Targeted Review" in the left-hand navigation. Source: American Medical Association, Centers for Medicare & Medicaid Services, Quality Payment Program

The Arizona Office of Economic Opportunity, through the Rural Health Transformation Program, has released two grant programs supporting rural physician retention, well-being, and transition to practice in Arizona. Two New Funding Opportunities Released The Arizona Rural Health Transformation Program shares the following announcement on behalf of the Arizona Office of Economic Opportunity. AOEO has officially released two Request for Grant Applications for: the Provider Retention & Well-Being Microgrant the Transition to Practice Program Provider Retention & Well-Being Microgrant Program The Provider Retention & Well-Being Microgrant Program supports rural physicians and other health care professionals through targeted microgrants designed to reduce burnout, strengthen workforce retention, and promote well-being. These investments help sustain a stable and resilient rural health workforce across Arizona. Applicants can find the application and associated attachments at the Provider Retention & Well-Being Microgrant Program page. Transition to Practice Program The Transition to Practice Program supports newly licensed physicians and other health care professionals in rural Arizona by offering resources and structured support to help them establish and sustain their practice in underserved communities. These investments expand access to care and build long-term workforce capacity in rural health systems. Applicants can find the application and associated attachments at the Transition to Practice page. About the Rural Health Transformation Program The Rural Health Transformation Program is federal funding designed to help rural communities offset changes in Medicaid funding and improve patient care. Each state was required to craft a proposal, which was submitted to the Centers for Medicare & Medicaid Services for approval in late 2025. While the state was not granted the full amount of funding it requested, the initial federal investment is enabling additional and much-needed support for rural healthcare in Arizona. The Arizona Medical Association proudly contributed to the state's proposal alongside hospitals, community health centers, behavioral health providers, nursing organizations, Medicaid health plans, and other key stakeholders throughout the development process. Questions? Contact Jacy Smith at jacy.smith@oeo.az.gov with questions about either funding opportunity. Source: Arizona Office of Economic Opportunity, Arizona Rural Health Transformation Program

Monthly virtual sessions from the Arizona Department of Health and ASU Health Observatory offer immunization guidance. A New Monthly Education Series A new monthly Vaccine Science & Practice ECHO series will launch Oct. 20 to provide health care professionals with evidence-based education and practical tools for supporting immunization care. The virtual ECHO program is a collaboration between the Arizona Department of Health and the ASU Health Observatory, and it's designed for physicians, pharmacists, nurses, medical assistants, and other health care professionals involved in administering vaccines or supporting immunization services. What Sessions Will Cover Monthly sessions will cover vaccine science, federal vaccine guidelines, recent changes to immunization recommendations, and national and Arizona-specific immunization data. Participants will also have an opportunity to discuss real-world clinical cases and strategies for communicating with patients and families about vaccines. CME/CEU and How to Register Free CME/CEU is available. The series begins Oct. 20, with monthly sessions continuing thereafter. Learn more and register for the series.