Sundar Subramanian, a partner at PricewaterhouseCoopers (PwC) consulting affiliate Strategy&, has joined population health ...

In 2026, the Centers for Medicaid and Medicare Services will implement a prior authorization for certain services covered ...

Many in the MAGA movement are in a state of anger and disbelief over the Justice Department and FBI’s memo disclosing that ...

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

AI can help improve care and reduce costs. But it can also lead to delays in care or even denials, all in the name of saving money.

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 ...

The second of two defendants from Nevada who were charged in Minnesota with conspiracy to commit voter registration fraud ...

OKLAHOMA CITY (KFOR) — The Centers for Medicare and Medicaid Services will be implementing prior authorization requirements ...

Amid increasing pressures from rising medical costs and market instability, major insurers are pulling or adjusting their 2025 earnings projections, signaling the start of a downturn in the industry ...

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 ...