Many private health insurers require medical providers to get approval before administering treatment, sometimes resulting in delayed or denied care for patients. Now, that tactic, known as prior ...
The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...
The program, called WISeR, aims to reduce wasteful spending and fraud in the Medicare system. Doctors and Democrats have raised concerns that the pre-approval process could delay or deny necessary ...
The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...
Cleveland-based MetroHealth has improved the speed and success of its medication prior authorization process with the help of AI, cutting submission times from 18 hours to around five minutes and ...
Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. Over the last several years, prior authorization has become a ...
Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many older adults choose original Medicare ...
CLEVELAND, Ohio — A new Medicare pilot program, the Wasteful and Inappropriate Service Reduction (WISeR) Model, is set to launch next year in Ohio and five other states, potentially changing how older ...
CLEVELAND, Ohio — A new Medicare pilot program set to launch next year in Ohio and other states could change the way older Americans access certain medical treatments, drawing sharp criticism from ...
Artificial intelligence will soon play a role in whether Medicare will pay for Ohioans' pain relief therapy and skin substitute bandages. Starting Jan. 1, technology will determine whether Medicare ...
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