News

Becker's ASC3d
CMS adds prior authorization for spine, pain management Medicare services: What ASCs need to know
CMS is adding prior authorization requirements for certain fee-for-service procedures under traditional Medicare as part of its new Wasteful and Inappropriate Service Reduction model. A total of 17 ...
HME News3d
Prior authorizations: Insurer pledges, tech plays & exemption pathway
In about a one-week span, the Department of Health & Human Services (HHS) and the Centers for Medicare & Medicaid Services ...
Rheumatology Advisor3d
Health Insurers Have Promised Prior Authorization Reform, HHS Says
Health insurance companies have pledged to improve prior authorization with 6 key reforms, according to the HHS.
Becker's Spine Review4d
The prior authorization reforms spine surgeons want from payers
As payers announce plans to improve prior authorizations, two spine surgeons discuss the changes that would make the most difference for them. Ask Spine Surgeons is a weekly series of questions posed ...
Fierce Healthcare5d
Payer Roundup—How premiums could increase from tariffs; insurer pans Medicaid data sharing with DHS
Below is a roundup of payer-centric news headlines you may have missed during the month of June 2025. | In June, Gold Coast ...
Healthcare Finance News5d
CMS launches prior authorization pilot for Original Medicare
The model will leverage AI and machine learning for prior authorization of services vulnerable to fraud or inappropriate use, ...
Healthcare Dive5d
CMMI to add prior authorization for some Medicare services
Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut ...
McKnight's Home Care5d
New CMS model adds prior authorization to traditional Medicare services
Home care providers are monitoring a new Centers for Medicare & Medicaid Services Innovation Center model that will add prior ...
Becker's Spine Review6d
CMS to add prior authorization for spine procedures in traditional Medicare
Some fee-for-service spine procedures in traditional Medicare will have prior authorizations added, according to CMS’ new Wasteful and Inappropriate Service Reduction model. CMS is partnering with AI ...
Fierce Healthcare6d
New CMMI model injects 'enhanced technologies' in Medicare prior authorization to limit fraud
The Centers for Medicare & Medicaid Services (CMS) rolled out an Innovation Center model Friday to test new prior ...
Becker's ASC6d
What’s going on with prior authorization?
Across the healthcare landscape, prior authorization is undergoing significant changes aimed at reducing administrative burden and expediting care delivery. Here are three major updates to know: 1.
KFF Health News6d
CMS Launches Prior Authorization Trial For Some Medicare Services
Health care service companies are being asked to join a program that relies on technology to review certain fee-for-service Medicare requests. A program-affiliated medical professional will give the ...