Can UHC Medicare Advantage members go to Brown Health hospitals for emergencies? We dug into this and other questions.

Trump admin to use AI for Medicare authorization denials, raising concerns about access to care and increased denials for ...

Provider organizations have answered the Department of Health and Human Services’ (HHS’) call for deregulation suggestions with their policy change wish lists tackling topics from prior authorizati | ...

Sanjay Doddamani, MD, MBA, a former senior advisor to the Center for Medicare and Medicaid Innovation, and internist and ...

In a recent roundtable, the Department of Health and Human Services and executives from top insurance providers pledged to address longstanding concerns around prior authorizations, aiming to reduce ...

A bill intent on reforming the pre-authorization process in Delaware passed both chambers and is now under consideration from Gov. Meyer.

In an about-face, the administration is cracking down on so-called skin substitutes, overused treatments that cost Medicare ...

Becker’s reported on six developments in CMS and Medicare news affecting spine surgery and physicians. 1. Some fee-for-service spine procedures in traditional Medicare will have prior authorizations ...

Funneling money to for-profit companies by rewarding them for denying health care coverage through using unproven, manipulable AI models is not the answer. The Trump Administration is bringing prior ...

The DME MACs in June indicated that prior authorizations for identical replacement power mobility devices after the five-year ...

States must begin verifying millions of Medicaid enrollees’ monthly work status by the end of next year — a task some critics ...

Discover key tips on Medicare Advantage plans and how to manage your healthcare needs effectively as you grow older.