CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

While health plans make headway on upcoming interoperability mandates associated with the Advancing Interoperability and Improving Prior Authorization Final Rule, revenue cycle teams are stalling amid ...

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 ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's ...

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 ...

CMS finalizes 2027 Medicare Advantage and Part D rule with changes to star ratings, supplemental benefits, and Part D coverage effective June 1.

Health data company Smile Digital Health and MCG Health are partnering in a move that will help payers meet the requirements of the Centers for Medicare and Medicaid Services Interoperability and ...

Collaboration delivers scalable infrastructure to help payers and providers prepare for new federal interoperability ...