A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare ...
Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...
CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits. The plan mandates electronic processes, faster decision timelines, and ...
A large portion of payers and providers have not started or are partially through implementing CMS API requirements, with compliance due by January 1, 2027. Key challenges include funding, developing ...
Healthcare and technology groups want Medicare Advantage plans included in the Centers for Medicare and Medicaid Services' proposed rule to expand access to health information and improve the prior ...
Drugs were left out of a 2024 rule streamlining prior authorizations, including by making decisions electronic and requiring payers to turn them around more quickly. The Trump administration is ...
The recently proposed Health Data, Technology, and Interoperability rule proposes the elimination of core patient-safety criteria. The significant change would pose avoidable risks to all who interact ...
CMS has proposed a 2026 rule to extend electronic prior authorization and interoperability requirements to prescription drugs under Medicare Advantage, Medicaid, CHIP, and ACA exchange plans. The ...
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