The concept of pre-authorizations was introduced with the best intentions: to control healthcare costs and prevent fraud. However, its implementation has led to a significant disparity in the ...

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A new AI tool is being tested in Oklahoma to process prior authorizations in Medicare. These Oklahomans say they're worried.

AI-generated summary reviewed by our newsroom. Read our AI Policy. WakeMed officials said Tuesday that United Health Care has stopped negotiating days before the deadline for reaching a Medicare deal, ...

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 ...

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 ...

Medicare enrollees in Washington and five other states could soon need preapproval for certain medical services — a familiar hurdle for commercial insurance plans, including Medicare Advantage, but ...

Berwick is a former administrator of the Centers for Medicare and Medicaid Services. He is a senior fellow for health policy and Ducas is the VP of health policy at the Center for American Progress.

For the first time, more Medicare enrollees received their Medicare benefits through a Medicare Advantage (MA) plan last year than through Traditional Medicare. We saw first-hand at the Center for ...

WakeMed officials said Tuesday that United Health Care has stopped negotiating days before the deadline for reaching a Medicare deal, an impasse that threatens to place its Medicare Advantage patients ...