Legislation Targets AI-Based Medicare Prior Authorization Pilot in Washington
U.S. Senators propose legislation to halt CMS AI-powered Medicare prior authorization pilot in six states including Washington due to care delay concerns.
2027 Medicare Advantage and Part D Proposed Rule: CMS Modernizes Quality Metrics and Risk Adjustment
CMS 2027 Proposed Rule aims to modernize Medicare Advantage and Part D programs with updates to quality metrics, risk adjustment models, and beneficiary protections. Key changes include Star Ratings revisions, incorporation of Inflation Reduction Act drug pricing provisions, and requests for stakeholder feedback on quality bonus payments and care coordination.
2026 Payer IT Modernization: CMS Compliance, Interoperability, and Cybersecurity Driving Outcomes
Discover how 2026 CMS compliance deadlines and cybersecurity expectations are reshaping payer IT with FHIR interoperability, prior authorization modernization, and outcomes-driven digital strategies.
Clever Care Partners with Blue Zones Health to Enhance Culturally Competent Medicare Advantage Care
Clever Care Health Plan partners with Blue Zones Health to connect Medicare Advantage members with providers focused on longevity and culturally competent preventive care in Southern California.
Curitics Health Solutions Names John Gorman Executive Advisor to Boost AI-driven Healthcare Tech
Curitics Health Solutions appoints John Gorman as Executive Advisor to advance AI-driven healthcare technology focused on Medicare Advantage, Medicaid, and value-based care.
MedPAC Discusses 2027 Medicare Payment Updates and Policy Adjustments
MedPAC reviews and recommends 2027 Medicare payment updates including base payment adjustments, Medicare Safety-Net Index changes, and outpatient payment policies.
Penn Highlands Healthcare Supports Multiple Medicare Advantage Plans for 2026
Penn Highlands Healthcare participates in various Medicare Advantage Plans for 2026, including UPMC for Life Plans, with some regional limitations in Pennsylvania.
Fitch Downgrades Humana Credit Ratings Amid Medicare Advantage Payment Cuts
Fitch lowers Humana's credit ratings due to sustained healthcare utilization and reduced Medicare Advantage bonus payments, impacting insurer financial strength.
Vermont Officials Advise Residents on 2026 Health Insurance Changes Amid Subsidy Expiration
Vermont faces rising health insurance premiums and coverage challenges in 2026 as enhanced ACA subsidies expire and Medicare Advantage plans withdraw, prompting officials to advise timely enrollment and offer guidance.
Senators Seek to Block AI-Driven Medicare Prior Authorization Pilot
U.S. Senators propose legislation to halt CMS's AI-driven Medicare prior authorization pilot, citing concerns over care delays and provider burden in six states including Washington.