Report: Arizona's Involvement in Federal Healthcare Advocacy

January 23, 2026

The Pulse of Policy: How Arizona’s Delegation is Shaping Medicine at the Federal Level

This past November, the Arizona Medical Association sent its delegation to Washington, D.C., for the American Medical Association’s Interim House of Delegates meeting.


Joined by colleagues from across the nation, Drs. Dowling, Leib, Jasser, Figge, Fagan, Baltazar, Kazi, and Rejbi stepped into the arena representing the voices of Arizona physicians and the profession’s future. The resulting deliberations painted a stark picture of the threats facing the practice of medicine, yet they also illuminated a clear, evidence-based pathway toward stabilization and renewal.

The following is a report of the proceedings, outlining the pathologies threatening our practice and the treatments we are prescribing through aggressive advocacy.


The Economic Siege: Payment Reform and the Private Practice Defense


The meeting opened with the proceedings of the Private Practice Physicians Section (PPPS), a gathering of more than 50 physicians dedicated to preserving the independent model of care. The atmosphere was one of urgent resolve. The central theme was the erosion of economic viability, specifically regarding the recently announced Medicaid reductions.

For Arizona, where Medicaid (AHCCCS) plays a vital role in our safety net, these reductions are not abstract budget adjustments; they are physiological shocks to the healthcare system. The delegation analyzed how these cuts threaten to alter care delivery and destabilize practice revenue. The consensus was clear: passive acceptance is not a strategy. Practices must engage in targeted advocacy to mitigate these disruptions, or risk a collapse in workforce capacity that will leave our most vulnerable patients without access to care.


Organization of Medical Association Presidents


Simultaneously, the Organization of Medical Association Presidents (OSMAP) convened to discuss a counter-offensive against the corporatization of healthcare economics. The discussion centered on the Multiplan Health Insurance Provider Litigation. This lawsuit alleges that major insurers colluded to artificially suppress payments for out-of-network services.

For Arizona physicians who have long battled opaque reimbursement structures, this litigation represents a rare opportunity to demand transparency and fair market restitution. ArMA has engaged Arnall, Golden, & Gregory LLC regarding potential inclusion as a litigant in this lawsuit. Stay tuned for more information. 


The Looming Threat: WISeR and the Algorithmization of Care


Perhaps the most critical development for Arizona physicians involves the new and controversial pilot program from the Centers for Medicare & Medicaid Services (CMS) known as the "Wasteful and Inappropriate Service Reduction" (WISeR) initiative.

Effective January 1, 2026, CMS introduced AI-driven prior authorization requirements for select outpatient Medicare procedures. Arizona is one of only six states selected for this pilot. The program targets categories such as skin and tissue substitutes and knee arthroscopy for degenerative joint disease.

The implications of WISeR are profound. We are witnessing the automation of denial. This model raises significant ethical and clinical concerns regarding the delay of critical care for older adults. By delegating medical necessity determinations to algorithms, CMS risks severing the patient-physician bond. The delegation’s stance is unequivocal: physicians electing not to submit prior authorization requests under this new regime will be subject to prepayment review. We must engage immediately to modify this program before it becomes an irreversible standard of care.

However, there is a counterbalance. Also taking effect on January 1, 2026, are new federal regulations mandating timeliness in processing prior authorization requests — 72 hours for urgent cases and seven calendar days for routine requests. This legislative victory provides a necessary check against the administrative friction that currently paralyzes practice operations.


The Administrative Burden: Confronting the "Prior Auth" Epidemic


The session on "Fixing Prior Authorization" revealed the staggering scale of administrative waste. Presenters underscored that prior authorization has metastasized from a cost-control mechanism into a barrier to care.

The AMA’s strategy is multifaceted, involving the deployment of tools like FixPriorAuth.org to aggregate data and support grassroots engagement. The House of Delegates (HOD) advanced policies to establish a national tracking system for authorization denials and advocated for "gold-carding" programs that exempt physicians with high approval rates from these onerous requirements.

Furthermore, Reference Committee J, which focused on insurer accountability, adopted vigorous new standards. The House voted to demand public reporting of denial rates and to investigate insurer financial gains derived from delayed care. In a significant move for clinical autonomy, the AMA will now advocate that low-cost medications and procedures should require no prior authorization whatsoever. This is a shift from defense to offense—demanding that the burden of proof lie with the insurer, not the clinician.


Protecting the Workforce: Scope, Visas, and Contracts


The integrity of the medical profession relies on maintaining rigorous standards of training. The Arizona delegation stood firm against the dilution of medical practice. So far this year, organized medicine has defeated more than 150 bills nationwide designed to inappropriately expand the scope of practice for non-physicians. The HOD adopted policies limiting laser surgery exclusively to MDs, DOs, or their equivalents, ensuring that complex surgical interventions remain in the hands of fully trained surgeons.

Yet, protecting the workforce also means ensuring we have a workforce. With one-fourth of U.S. physicians being International Medical Graduates (IMGs) or visa holders, the delegation opposed changes to the H-1B visa program that would impose exorbitant fees, up to $100,000 to sponsor a physician. For Arizona’s rural communities, which rely heavily on IMGs to fill critical gaps in primary care, such fees would be catastrophic. The delegation supported resolutions to increase transparency in residency programs for IMGs, recognizing that our ability to serve rural Arizona depends on a diverse and accessible talent pipeline.

Additionally, the changing landscape of employment was addressed. As consolidation forces more physicians into employed models, the AMA took a strong stance against restrictive covenants. The House directed the development of model legislation to prohibit "non-compete" clauses and indemnification requirements that force physicians to pay for tail insurance or assume liability for employer negligence.


Public Health and the Ethics of Innovation



Beyond the economics of practice, the meeting addressed the moral obligations of medicine. In the realm of public health, the delegation supported removing "red flag" designations for buprenorphine mono-products, ensuring that the treatment of opioid-use disorder is not stigmatized or bureaucratically obstructed.

Mental health also took center stage. Following the rescission of over $1 billion in federal mental health grants — a move that disproportionately harmed rural schools, the AMA resolved to advocate for sustained, automatic continuity protections for school-based mental health funding.

Finally, regarding the rapid integration of technology, the House adopted Reference Committee J’s policy on Artificial Intelligence. The consensus is that AI must be a tool for augmented intelligence, not a replacement for human judgment. New policies ensure that payer AI systems used for prior authorization are subject to physician oversight and strict transparency standards.


Conclusion: The Road Ahead


The proceedings of the Interim Meeting demonstrate that the threats to our profession are not static; they are evolving. From the AI-driven scrutiny of the WISeR pilot in Arizona to the courtroom battles against insurance giants, the landscape is shifting.

However, the actions taken by your delegation prove that we are not powerless. By leveraging the collective strength of the AMA and ArMA, we are rewriting the rules of engagement. We are moving from a position of resilience to one of resistance and reform.

The medicine of the future is being legislated today. Through our continued engagement, we ensure that those who control the legislation hear directly from those who hold the stethoscope.

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 .