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 ...
CMS published its interim final rule for state implementation of Medicaid work requirements June 1. HR 1’s effect on state Medicaid budgets has sparked concern. The law outlined how low-income, ...
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 ...
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 ...
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 ...
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 ...
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 ...
The proposed rule on interoperability standards and prior authorization could lead to significant change in CMS. Prior authorization has become one of the clearest points where administrative ...
McDermott+ is pleased to bring you Regs & Eggs, a weekly Regulatory Affairs blog by Jeffrey Davis. October 30, 2025 – For those of you who haven’t heard the news, the Centers for Medicare & Medicaid ...
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