Humana has released details about additional, upcoming organizational improvements to encourage a faster prior authorization ...

Inappropriate denials for prior authorization and coverage of medically necessary services are a pervasive problem among certain plans in the Medicare Advantage (MA) program.

CMS issued the 2026 Medicare Physician Fee Schedule, or PFS, proposed rule on July 14.It includes a 0.75% increase to the ...

Humana is taking a second bite at the apple to improve its sunken MA stars, filing an edited complaint with a Texas court on ...

While Medicare Advantage (MA) penetration has skyrocketed, forcing home health providers to adapt their businesses. MA home health utilization, however, ...

The Coalition for Health AI is convening a fast-tracked, priority team to determine how AI could best be used to implement ...

Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to ...

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 ...

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 ...

CMS Monday proposed a 2026 physician payment rule that proposes a new payment model focused on improving chronic disease management.

In an about-face, the administration is cracking down on so-called skin substitutes, overused treatments that cost Medicare more than $10 billion last year.

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 ...