CMS orders corrective action plan for AI vendor in Medicare prior authorization pilot
(By: Andrew Cass for Becker’s Hospital Review) CMS is requiring one of the companies it hired to use artificial intelligence
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Prior Authorization
31 House Democrats press CMS on Medicare prior authorization pilot
(By: Elizabeth Casolo for Becker’s Hospital Review) Thirty-one House Democrats are seeking more information on CMS’ Wasteful and Inappropriate Service Reduction
Read MoreMedicare’s AI Push Snarls Patients and Doctors in Errors and Delays
(By Darius Tahir for KFF Health News published June 23, 2026) Bill Curry, 65, raises cattle on the same land
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Is Medicare WISeR model working?
The Medicare WISeR (Wasteful and Inappropriate Service Reduction) Model is a six-year Medicare initiative, starting January 1, 2026, that uses
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Unusually high rates of prior authorization denials
The Department of Health and Human Services’ inspector general’s latest report found three specific Medicare Advantage plans had the highest
Read MoreMedicare Advantage in 2026: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization
(Authors: Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia Neuman for The Kaiser Family Foundation Published: Jun 5, 2026)
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Massachusetts prior auth regulations take effect: 6 things to know
(By: Elizabeth Casolo for Becker’s Hospital Review) Prior authorization reforms in Massachusetts went into effect June 5. Democratic Gov. Maura
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Major insurers share prior authorization requirements for just 14% of services: Study
(By: Jakob Emerson for Becker’s Hospital Review) Across three major commercial insurers, only 14% of procedure codes that triggered a
Read MoreCMS taps 30 healthcare organizations for prior authorization initiative
(By: Naomi Diaz for Becker’s Hospital Review) The Centers for Medicare & Medicaid Services is launching a new initiative aimed
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4 recommendations to bring oversight to AI-driven prior auth: MACPAC
(By: Elizabeth Casolo for Becker’s Hospital Review) The Medicaid and CHIP Payment and Access Commission approved recommendations to boost transparency with
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