The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 ...

The proposed rule aims to improve prior authorization for prescription drugs by establishing and requiring electronic prior ...

Several lawmakers are pressing the Centers for Medicare & Medicaid Services (CMS) to expand Medicare’s coverage of substance abuse disorder to address key gaps exacerbating the addiction crisis. Rep.

CMS is cracking down on AI use in Medicare Advantage. Medicare Advantage (MA) insurers can use AI and algorithms to assist in making coverage decisions, but CMS is warning the insurers that they must ...

Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic ...

Real world data (RWD), which is data from actual patient treatments, provides valuable information on safety and effectiveness of innovative new health technologies, often at significantly lower cost ...

The Centers for Medicare & Medicaid Services has pledged to issue new guidance on resident abuse after a federal watchdog found the agency was failing to use claims data to spot potential cases of ...

Centers for Medicare and Medicaid Services Administrator Seema Verma on Tuesday announced changes to overhaul the meaningful use EHR incentive program, including equipping patients with access to ...

Medicare Advantage (MA) plans are increasingly enrolling veterans. Because MA plans receive full capitated payments regardless of whether or not veterans use Medicare services, the federal government ...

This article discusses drug discount coupons and services, as well as the associated rules for people enrolled in Medicare. It then looks at the Medicare drug plans and when a person might want to use ...