Wasteful and Inappropriate Service Reduction (WISeR) model will use AI to review items and services that CMS deems vulnerable ...

The post Federal officials push for prior auth reform appeared first on Self Employed.

As we age, prescription medications often become an essential part of managing our health. Whether it's for controlling blood pressure, treating diabetes or easing arthritis ...

Prior authorization coming to Medicare in 2026 ...

Many with menopause symptoms miss treatment due to high costs and insurance denials. A California bill seeks to mandate ...

A new CMS model will introduce new prior authorization requirements to traditional Medicare in six states, raising provider concerns about administrative burden.

Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the ...

As CMS gears up to implement its new Wasteful and Inappropriate Service Reduction model, one orthopedic surgeon is not too concerned about its day-to-day impact on the addition of prior authorization ...

The Centers for Medicare and Medicaid Services (CMS) will implement prior authorization requirements for certain traditional ...

Gold Card’ programs were supposed to ease prior authorization burdens for doctors whose treatment recommendations are ...

A qualitative study explores how MA plan leaders, kidney care managers, and dialysis providers perceive the benefits, risks, ...

Skeptics note that efforts to streamline the much-despised prior authorization system have failed twice before.