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 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 ...

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 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 ...

BOSTON--(BUSINESS WIRE)--TechM, a leading global provider of technology consulting and digital solutions to enterprises across industries and Abacus Insights, the industry leader in data usability and ...

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 ...

CMS is mandating that certain health plans adopt API-based electronic prior authorization (ePA) systems by January 1, 2027, following new 2026 turnaround time standards. Platforms like CoverMyMeds, ...

The Centers for Medicare and Medicaid Services has long championed interoperability as a cornerstone of providing better care, improving patient empowerment, and reducing administrative burden.

CMS on May 20 proposed a rule that would cap certain state Medicaid payments and align them more closely with Medicare rates. The proposed rule would create new limits for Medicaid state-directed ...

BOSTON, MA / ACCESS Newswire / January 14, 2026 / 1upHealth, a leader in health data interoperability, today announced that Advanced Health, a Coordinated Care Organization in Oregon, will leverage ...