The prior authorization changes, announced this week, are part of the Centers for Medicare & Medicaid Services' (CMS')2024 update of policy changesfor Medicare Advantage and Part D pharmacy plans Medicare Advantage plans' business practices have raised significant concerns in recent years. More than...
An effective way to cut down on overuse of potentially harmful imaging, or a prior authorization-esque burden on physicians who order needed tests? Texas physicians see Medicare's "appropriate use" system for advanced imaging both ways. As of Jan. 1, physicians ordering advanced imaging tests fo...
Lawmakers and beneficiary advocates are pressing HHS to pause the impending expansion of a Medicare model that relies on prior authorization to reduce improper ambulance payments, arguing that unless gaps in the program are filled with non-emergency transport, going nationwide will harm patients with ...