Transforming Medicare: AI-Driven Prior Authorization Model Launches in 2026
Discover Medicare's innovative AI-driven WISeR Model, advancing prior authorization efficiency and regulatory compliance starting in 2026. Learn more now!
Medicare Telehealth Flexibilities Extended Until January 2026; AI Pilot for Prior Authorization Begins
Medicare telehealth flexibilities are extended through January 2026, maintaining access for rural and elderly patients. Medicare also launches an AI pilot for prior authorization to streamline outpatient service approvals.
CMS Launches AI For Medicare Prior Authorization Across Six States
The Trump administration launches an AI-driven pilot program in six states to manage Medicare prior authorization, raising industry concerns over claim denials and AI incentives.
New Legislation in North Dakota and Nebraska on Prior Authorization Timelines
North Dakota and Nebraska have reformed prior authorization processes for health insurance. Learn how these changes improve response times and regulatory compliance.
Study Highlights Elevated Administrative and Financial Burdens in Medicare Advantage for Patients with Multiple Chronic Conditions
Analysis reveals higher administrative and financial burdens for Medicare Advantage enrollees with multiple chronic conditions, highlighting the impact of managed care on treatment complexity.
AHA Urges HHS and CMS to Enforce Prior Authorization Reforms
The American Hospital Association urges CMS and HHS to enforce prior authorization reforms to reduce hospital staff workload and patient delays, emphasizing implementation of electronic standards and monitoring compliance.
AI-Assisted Prior Authorization Pilot Launches in Washington Medicare
The federal government starts a 6-year AI-assisted prior authorization pilot in Washington and five other states to improve Medicare coverage decisions for costly procedures.
CMS Pilot Uses AI for Medicare Prior Authorization, Faces Oversight Calls
CMS launches AI-driven pilot to streamline Medicare prior authorization for select services, prompting legislative calls for independent oversight to ensure patient safety and regulatory compliance.
CMS Launches AI-Driven Prior Authorization Pilot for Traditional Medicare in Washington
CMS to start AI-driven prior authorization pilot for traditional Medicare in Washington and five other states in 2026, targeting low-value procedures to reduce waste and improve compliance while maintaining clinician oversight.
CMS Launches Prior Authorization Pilot in Traditional Medicare to Control Costs
CMS initiates a six-state pilot requiring prior authorization in traditional Medicare to target overuse and cut costs, testing expanded regulatory controls familiar in Medicare Advantage.