More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

A CMS pilot program will require providers in six states to submit select Medicare services for AI-enabled prior authorization or post-service medical review.

Medicare in January will begin AI-powered pre-treatment reviews for select health services in a major policy change that's aimed at rooting out unnecessary care — but alarming providers. Why it ...

Transcure announced the introduction of a structured lineup of AI medical billing agents designed to address distinct functions across the revenue cycle management process. The announcement outlines a ...

Most non-emergency care at non-VA facilities requires the VA's approval before you schedule. This includes routine appointments, specialist consultations, procedures and diagnostic tests that aren't ...

Lawyers for a former Alberta Health Services (AHS) board member claim a self-described political fixer, along with an ...

The Michigan Department of Health and Human Services has issued a request for proposal for entities interested in serving as the state’s pharmacy benefit administrator. The initial contract will be ...

Medicare’s expanded telehealth rules created during the pandemic will end after Jan. 30, 2026, unless Congress acts to extend ...

Sacramento Telehealth Company Positions Multi-Form Compounded Semaglutide Access Through Licensed Medical Providers Ahead of ...

By Karen Ferguson. The status quo of the American health care system is doing damage to families and businesses in real time. Pharmacy Benefit Managers, drug purchasing “middlem ...

A work stoppage could be on the horizon for the Cincinnati Cyclones amid a labor dispute between the ECHL and the union ...

Health care executive coaches explain why leaders aren't feeling holly-jolly this year. Plus, Shiv Rao on Abridge's next moves.