Discover how 2026 CMS compliance deadlines and cybersecurity expectations are reshaping payer IT with FHIR interoperability, prior authorization modernization, and outcomes-driven digital strategies.
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.
CMS initiates the WISeR Model in six states to employ AI-driven prior authorization, targeting reduced low-value services and Medicare spending under traditional fee-for-service programs.
The new WISeR Medicare pilot uses AI to manage prior authorizations, impacting care access and insurer incentives in six states, with significant implications for rural healthcare.
ASCRS addresses 2025 Medicare cuts, CMS proposals impacting cataract surgery reimbursement, scope of practice expansions, and advocates for fair payment and regulatory reforms in ophthalmology for 2026.
Aetna integrates pharmacy prescriptions with medical procedure prior authorizations to streamline healthcare approvals and enhance payer-provider efficiency through AI-driven digital tools.
The Trump administration introduces WISeR, an AI-driven pilot program expanding prior authorization in Medicare to reduce wasteful services, raising industry and regulatory debates on care delays and oversight.
The Trump administration's Medicare pilot introduces AI-driven prior authorization to reduce waste and control costs, raising regulatory and patient care concerns.
The Trump administration's WISeR pilot program introduces AI-driven prior authorization in Medicare to reduce waste and fraud, raising concerns over patient care and regulatory oversight.
Explore recent legislative and CMS efforts to reform prior authorization in U.S. healthcare, focusing on bipartisan bill progress, CMS regulations, and new experimental models to streamline Medicare prior authorization processes.
