Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

Medicare is launching a significant new prior authorization initiative under the CMS Innovation Center’s Wasteful and Inappropriate Service Reduction (WISeR) model. Beginning January 2026, select ...

Starting January 1, 2026, Medicare Original will require an additional step for 17 specific services. This is a federal ...

Known as the Wasteful and Inappropriate Service Reduction (WISeR) model, it will require prior authorization for 17 services ...

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 ...

This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. The CMS will test a new model beginning next year ...

The Meeting kicked off with the 4th NCOIL Open Insurance Legislators Foundation (ILF) Scholarship Golf Outing on Wednesday afternoon. The annual event helps to invigorate the ILF Scholarship Fund ...

Prior authorization — in which a patient needs approval from the health plan before proceeding with a medical service — has long created a rift between payers and providers. It has gotten such a bad ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

Of the many tools that payers use to control costs, prior authorization ranks high on the list of what providers and patients find particularly vexing. However, Health Care Service Corporation hopes ...