A new Medicare pilot program will require prior authorization for certain medical procedures, using AI to approve or deny coverage A new program from the Centers for Medicare and Medicaid Services ...

CMMI has spent more than a decade learning which organizations consistently deliver high-value care. The next step is to let ...

Kim Brandt, CMS’s chief operating officer and deputy administrator, said AI tools are helping the agency stop money from going out the door to fraudsters.

Revisions to the US Centers for Medicare & Medicaid Services’ (CMS) competitive bidding programme (CBP) have been welcomed by the medtech industry, despite remaining concerns. The CMS has outlined ...

The Centers for Medicare & Medicaid Services (CMS) announced Wednesday operational details for the next stage in its competitive bidding program despite ongoing opposition from patient advocacy groups ...

Bipartisan efforts to lower prescription drug costs remains a core focus for the US Congress. Effective October 1, 2024, the Centers for Medicare and Medicaid Services (CMS) has announced the ...

As discussed in last week’s Regs & Eggs blog post, the US Department of Health and Human Services (HHS) recently released additional budget documents to support the department’s fiscal year (FY) 2026 ...

The Centers for Medicare & Medicaid Services announced a seven-prong update to the Civil Money Penalty Reinvestment Program on Monday. The agency has increased the project funding cap by 20% and also ...

CMS is expanding Medicare’s Recovery Audit Contractor program to Medicare Advantage, as required by the ACA. The program was originally implemented for Medicare Parts A and B in January 2010. CMS ...

Seniors across the nation are facing significantly higher monthly premiums due to systemic billing inaccuracies and alleged ...