When you are sick or in pain, the prior authorization process can be frustrating and will sometimes result in a denial. If you've never been through the process, prior authorization is a requirement ...
CLEVELAND, Ohio — A new Medicare pilot program set to launch next year in Ohio and other states could change the way older Americans access certain medical treatments, drawing sharp criticism from ...
GoodRx reports that starting January 2026, original Medicare will require prior authorization for certain services in six ...
Prior authorization is the process through which a doctor seeks approval from a person’s health insurance plan before ordering a specific medication or medical service. Original Medicare (parts A and ...
Artificial intelligence will soon play a role in whether Medicare will pay for Ohioans' pain relief therapy and skin substitute bandages. Starting Jan. 1, technology will determine whether Medicare ...
The rate of Medicare Advantage (MA) claims has escalated in recent years, prompting medical and government scrutiny of prior ...
Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut funding for what it deems medically unnecessary care. The Center for Medicare ...
In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.
The CMS will soon make it more difficult for providers in six states to get reimbursed in Medicare for certain medical procedures it has deemed “low value,” but some stakeholders worry it could lead ...
The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...
The program, called WISeR, aims to reduce wasteful spending and fraud in the Medicare system. Doctors and Democrats have raised concerns that the pre-approval process could delay or deny necessary ...
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