Over 6 million Americans on Medicare will now need to get prior authorization from AI for these 17 procedures

A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

List of Health Systems Dropping Medicare Advantage Plans in January

Several major health systems are dropping Medicare Advantage plans in the new year. The hospitals are ending their acceptance ...
CIDRAP

Medicaid program to stop requiring providers to report childhood vaccine data

Doctors and other health professionals who accept Medicaid and the Children’s Health Insurance Program (CHIP) are typically ...

Minnesota removes 800 Medicaid providers from system in effort to tackle systemic fraud. Here’s how it’ll impact access to care

The state's Department of Human Services says this move will “strengthen the integrity of Minnesota’s Medicaid programs and services." ...

New Medicare Program: Full List of Services That Will Need Prior Approval

Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial ...

Medicare Is Spending Lots More On Rx Drugs: Why That’s A Good Thing

Medicare's cap on out-of-pocket costs helps cancer patients and others taking expensive drugs. With less financial burden, ...

How New Medicare Payment Plans May Improve Patient Care And Save Money

They compensate providers such as doctors and hospitals on quality rather than volume of care, and they engage and assist ...
Just The News

First negotiated, lower Medicare drug prices have gone into effect

Savings for Part D and Advantage enrollees depend largely on which plan they’re enrolled in, as not all plans are the same.

PECOS Medicare System: Online Enrollment for Providers Explained

Explore PECOS, the Provider Enrollment, Chain, and Ownership System, a streamlined online tool for healthcare providers to manage Medicare enrollments.
Fierce Healthcare

CMS may soon propose Medicaid provider tax regulation

The Centers for Medicare & Medicaid Services (CMS) submitted a regulation to the Office of Management and Budget (OMB) that could upend Medicaid provider tax program financing. The regulation is ...
Health Affairs

Assessing Provider Adoption Of Medicare Advanced Alternative Payment Models

The Centers for Medicare and Medicaid Services (CMS) has set an aggressive goal that by the year 2030 all Medicare beneficiaries with Parts A and B will be in a care relationship with accountability ...