CMS WISeR Model Launches AI-Driven Prior Authorization in Medicare
CMS's WISeR Model introduces AI-powered prior authorization for Medicare outpatient procedures, impacting approval times and denials in six states starting 2026.
CMS Proposed 2027 Medicare Advantage and Part D Changes Focus on Simplification and Oversight
CMS releases Proposed 2027 Rules for Medicare Advantage and Part D, emphasizing Star Ratings simplification, marketing oversight updates, expanded risk adjustment data use, and Part D redesign implementation.
Medicare Open Enrollment Deadline Approaches for 70M Beneficiaries
Nearly 70 million Medicare beneficiaries face the approaching open enrollment deadline. Learn how to navigate Medicare.gov for enrollment and potential cost savings.
Medicare Part D Coverage Shrinks in 2026 Amid Plan Reductions and Cost Shifts
Medicare Part D faces significant plan reductions and rising costs in 2026. Beneficiaries must review their drug plans before the December 7 deadline to avoid premium hikes and coverage losses.
Seattle Man Sentenced for $1M Medicare Fraud Scheme Involving Lab Testing
An Everett-based lab operator was sentenced to prison for a $1.17M Medicare fraud scheme involving fraudulent billing for unperformed COVID-19 and respiratory tests. The case underscores ongoing regulatory challenges.
HHS Ends Longstanding Public Comment Requirement, Drawing Industry Concern
The Department of Health and Human Services ends the Richardson Waiver, impacting public notice and comment in healthcare rulemaking. Industry groups express concerns over transparency and stakeholder engagement.
Medicare Cost Increases in 2026 Spotlight Value of Supplemental Insurance
Rising Medicare premiums, deductibles, and coinsurance rates in 2026 increase retiree healthcare expenses. Medicare supplemental insurance can help manage these escalating costs.
CMS Launches ACCESS Model to Advance Technology-Enabled Chronic Care in Medicare
CMS introduces ACCESS model to enhance technology-supported care and outcome-based payments for Medicare patients with chronic conditions starting in 2026.
Medicare 2026: Rising Costs and Fewer Plan Options Challenge Beneficiaries
Medicare beneficiaries face higher Part B premiums, fewer Part D plans, and Medicare Advantage cancellations in 2026, making open enrollment critical for coverage decisions.
Medicare 2026: Rising Premiums and Fewer Plan Choices Impact Beneficiaries
Learn about key changes to Medicare in 2026 including rising Part B premiums, fewer Part D plans, and the impact of Medicare Advantage plan cancellations on beneficiaries. Understand market trends and enrollment advice.