The Medicare Access and CHIP Reauthorization Act, or MACRA, is coming soon, and with it CMS's Quality Payment Program, which requires providers who bill Medicare more than $30,000 a year to report ...

On December 13, 2022, CMS is set to publish in the Federal Register a proposed rule (Proposed Rule) requiring certain Medicare, Medicaid, Children’s Health Insurance Program, and Qualified Health Plan ...

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 ...

The CMS is once again tackling prior authorization in its new rule proposed Tuesday. Prior authorization, a process in which a physician must get the green light from an insurer for medication or ...

Healthcare industry stakeholders made their case to leaders in President Donald Trump's health department last week about the need to improve the nation's health information technology infrastructure.

The WEDI baseline survey shows many providers and payers have yet to start implementing the requirements of the Centers for Medicare and Medicaid Services' Advancing Interoperability and Improving ...

A woman walks under a sign of big data analytics Palantir at their stand ahead of the World Economic Forum (WEF) annual meeting in Davos on May 22, 2022. (Photo by FABRICE COFFRINI/AFP via Getty ...

The 2026 CMS Prior Authorization Final Rule is reshaping healthcare operations by shortening decision timelines, requiring specific denial reasons, and increasing transparency. Providers are turning ...