A large portion of payers and providers have not started or are partially through implementing CMS API requirements, with compliance due by January 1, 2027. Key challenges include funding, developing ...
CMS has finalized a 2.6% payment increase for inpatient services, boosted DSH payments, established new interoperability rules for prior authorization, and confirmed the launch of a controversial ...
Humata Health, the leader in AI-powered medical review technology, today announced it has joined the Centers for Medicare and ...
Healthcare and technology groups want Medicare Advantage plans included in the Centers for Medicare and Medicaid Services' proposed rule to expand access to health information and improve the prior ...
The days of faxed forms and days-long waits for prior authorization approvals are officially ending under the new CMS 2026 rules. With the Interoperability and Prior Authorization Final Rule now in ...
As of February, a share of payers and providers had not yet started working toward the application programming interface requirements established by CMS’ interoperability and prior authorization final ...
On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule[1] that would require faster prior authorization (“PA”) decisions, expand electronic PA to drugs, ...
CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits, introducing electronic workflows, faster decision timelines, and greater ...
As the deadline for the CMS Interoperability and Prior Authorization Final Rule approaches, new data shows that providers are losing confidence in their ability to meet the mandate. As the healthcare ...
JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity®, the nation’s largest real-time health information network, will join two leading health plans to demonstrate insights and best practices gleaned from ...
McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. November 4, 2025 – Trick or treat! On Halloween evening, the Centers for Medicare & Medicaid Services ...
A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare Advantage prior authorization requests for medications to 24 hours and ...
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