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.

Explore effective strategies for U.S. healthcare professionals to navigate and overcome prior authorization denials, including regulatory context, appeals process insights, and advocacy tools.

The Medicare program will start an AI-driven prior authorization pilot for certain procedures in traditional Medicare, aiming to improve cost efficiency and coverage decisions. This initiative launches in six states with plans for potential expansion.

CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.

Analysis shows a 25% increase in U.S. private insurer prescription drug denials from 2016-2023, driven by rising drug costs and claim automation. Insights into industry impact and reform efforts.

Alaska's SB 133 mandates 72-hour decision deadlines for health insurance authorizations, increases transparency, and protects patients with chronic conditions, effective 2027.

Alaska's new Senate Bill 133 mandates faster health insurance authorization decisions and increased transparency, enhancing patient access and insurer accountability effective 2027.