"These shortages aren't just about an insufficient supply; they're fueled by burnout," said Dr. Paola Ballester, MD, ...

Taking a page from the private insurance industry's playbook, the Trump administration will launch a program next year to ...

AHA comments on the Medicare Payment Advisory Commission’s preliminary analysis of the association between Medicare Advantage (MA) enrollment changes and hospital finances shared during the September ...

AHA supports the Administrations role in facilitating the health insurer pledge to reform prior authorization processes announced on June 23.

Gov. Jared Polis ordered the Colorado Department of Health Care Policy and Financing to reinstate prior authorization for ...

Few tools in healthcare are as essential — or as misunderstood — as prior authorization. Designed to protect patients from overly expensive or unnecessary ...

Emergency rooms are the last functioning front doors to American healthcare. As an emergency medicine physician in one of ...

Prior authorization has become a hot-button issue in health care, and the National Council of Insurance Legislators will tackle the issue at its annual meeting in November. A draft of NCOIL’s Prior ...

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 CMS will soon make it more difficult for providers in six states to get reimbursed in Medicare for certain medical procedures it has deemed “low value,” but some stakeholders worry it could lead ...

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 ...

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 ...