CMS

Federal and commercial stakeholders have pledged to streamline the often burdensome prior authorization process ...

AUGUST 20, 2025

CMS has released one of its largest annual proposed payment rules, the Hospital Outpatient Prospective Payment ...

AUGUST 14, 2025

Two COVID-19 vaccination reporting requirements have been removed by the CMS regarding Medicare payment ...

AUGUST 7, 2025

One of Medicare’s primary reimbursement policies adds costs to a health system that is already spending at ...

SEPTEMBER 5, 2024

Medicare Advantage and other health plans are starting to pay more attention to medication adherence, social ...

JUNE 22, 2024

Concerns are growing about the increasing use of artificial intelligence to review—and in many cases ...

FEBRUARY 27, 2024

Although inpatient payment rules have been in place since their fiscal year start on Oct. 1, 2023, all other sites ...

FEBRUARY 13, 2024

Pharmacy benefit managers have responded to a new CMS rule requiring them to account for all ...

DECEMBER 26, 2023

Current U.S. government healthcare plans provide inadequate services for patients with dementia, who face high ...

NOVEMBER 21, 2023

Telling the patient’s story accurately, completely and in a codable fashion is absolutely essential to data ...

OCTOBER 23, 2023

CMS is launching the Guiding an Improved Dementia Experience (GUIDE) Model nationwide.

SEPTEMBER 27, 2023

One year after a 2022 Supreme Court decision that the CMS did not have the authority to lower reimbursement rates ...

SEPTEMBER 8, 2023