A CMS pilot program will require providers in six states to submit select Medicare services for AI-enabled prior authorization or post-service medical review.

If you’re about to turn 65 and know it’s time to start receiving Medicare, don’t assume that it’s just going to come to you automatically. Yes, you can qualify for Medicare eligibility when you’re 65; ...

Surveyed medical groups reveal burdens have increased in the past 12 months, resulting in delays or denials for necessary care. Despite scrutiny of prior authorization practices in Medicare Advantage ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

As the Trump administration expands traditional Medicare coverage in ambulatory surgical centers (ASCs), the industry will face new quality requirements and concerns about costs. The Centers for ...

Between rising Medicare supplement costs and the risks of a Medicare Advantage plan, it can be tough for seniors to make the ...

In a proposed rule issued Monday, the Centers for Medicare and Medicaid Services announced it would relieve the burden on healthcare providers and save them over $1 billion a year by removing Medicare ...

One of the biggest areas of confusion about Medicare is whether, and when, it covers home care. Partly, that depends on the distinction between “home care” and “home health care.” But it’s also about ...

You might think that if you’re 65 or older and need a wheelchair or electric scooter to get around, Medicare would automatically cover it. But, as with so many areas of Medicare, things aren’t quite ...