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 ...

The third round of the Medicare Drug Price Negotiation Program is moving forward with full manufacturer participation. The program, created under the Inflation Reduction Act, allows CMS to directly ...

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.

Medicare had banned coverage of weight-loss drugs for 23 years, and what happens next isn't as simple as the headlines ...

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 ...

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 ...

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 ...

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 ...

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 ...

The Medicare Payment Advisory Commission released its annual report to Congress March 12, which revealed key data points about the sustained growth of the ASC industry and the U.S’s overall healthcare ...

The primary goal for CMS must be to ensure that corrective actions are in place so that improper payments can be reduced, says GAO. What are the Centers for Medicare & Medicaid Services (CMS) doing to ...