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.
Washington's Medicare Adopts AI-Driven Prior Authorization Pilot in 2026
Starting in 2026, Washington state will implement an AI-driven prior authorization pilot for traditional Medicare, raising new compliance and access challenges. Learn about the pilot's impact on Medicare claims processing and healthcare providers.
UnitedHealthcare to Remove Prior Authorizations for Select Imaging Procedures in 2026
UnitedHealthcare will stop requiring prior authorizations for certain nuclear imaging, obstetrical ultrasound, and echocardiogram procedures starting in 2026, across multiple plan types including Medicare Advantage and commercial plans.
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.
2024 Health Policy Updates: Medicaid, Medicare, Telehealth, and Administrative Reforms
An in-depth analysis of 2024 U.S. healthcare policy updates affecting Medicaid, Medicare payments, telehealth, and administrative reforms impacting medical groups and physicians.
Congressional Opposition Mounts Against CMS Medicare Prior Authorization Expansion
Congresswoman Maggie Goodlander and colleagues urge CMS to halt the proposed expansion of prior authorization in Traditional Medicare, citing risks to patient care and administrative burdens.