The CMS program known as the Wasteful and Inappropriate Service Reduction (WISeR) model requires PA for 17 services, but Carol Howard, VP of innovation and adoption at Janus Health, says she can see ...

The Center for Medicare and Medicaid Innovation (CMS) has officially announced which producers will require prior ...

Lawmakers on Thursday explored the merits of a bill that would block the Centers for Medicare & Medicaid Services (CMS) from ...

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

The Centers for Medicare and Medicaid Services says 25% of spending is fraudulent or being abused by providers. Carol Howard, ...

The AHA Oct. 23 recommended changes to the CMS' Wasteful and Inappropriate Services Reduction model to address multiple concerns. The model is designed to use technology-enabled prior authorization to ...

SunKnowledge today is among the best-known names in business process outsourcing for all kinds of prior authorization challenges and struggles. NEW YORK, NY, UNITED ...

In October, CMS announced the launch of a new prior authorization demonstration that would introduce new requirements for select services. This comes just four months after news of an agreement ...

The Trump Administration is bringing prior authorizations (PAs), the mandatory preapproval before insurance covers health care services, to Traditional Medicare. The government plans on using ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use of prior authorization in Medicare. On the one hand, there is the effort ...