News

Prior Authorization Coming to Traditional Medicare Starting in 2026
The Centers for Medicare and Medicaid Services (CMS) will implement prior authorization requirements for certain traditional ...
HME News4d
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 Advisor4d
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 ASC4d
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 ...
Becker's Spine Review5d
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 ...
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 Dive6d
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 Care6d
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 ...
WINK News13d
Electronic health pre-approvals in Florida promise quicker care
Health insurance companies are set to streamline, simplify and reduce the pre-approval process by transitioning to an ...
Insurers vow to make prior authorization for treatment easier. What that means.
Major insurers say they’ll ease up on the prior-authorization practice that can delay necessary care for patients.
Highmark joins major insurers in prior authorization reform
Highmark is among the more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the ...