The Centers for Medicare & Medicaid Services (CMS) has unveiled a new initiative aimed at improving prior authorization ...

Medicare is requiring more pre-treatment approvals in its fee-for-service program in a bid to root out unnecessary care, ...

The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization ...

In fiscal 2023, the most recent year for which detailed financial information is available, Medicaid’s net cost was $894.2 ...

The largest U.S. insurers agreed Monday to streamline their often cumbersome preapproval system. Here are five takeaways.

The go-broke dates for Medicare and Social Security’s trust funds have moved up as rising health care costs and new legislation affecting Social Security benefits have contributed to closer projected ...

The Centers for Medicare & Medicaid Services (CMS) is a federal agency that provides health coverage to millions of people. It oversees programs like Medicare, Medicaid, and CHIP. The CMS works ...

CMS recently released the 2023 Quality Payment Program (QPP) Participation and Performance Results At-a-Glance (PDF), which includes high-level metrics on participation, scoring and Medicare payment ...

These are not duplicate programs; they are complementary. Medicaid pays for what Medicare does not: Medicare premiums, co-pays and other out-of-pocket costs, and vital services like nursing home care.

CMS draft guidance includes Medicare Part B drugs in 2026 price negotiations, with new prices set for 2028. Public comment period on CMS proposal is open until June 26, 2025. Market-moving news ...

Dual eligibility income thresholds for Medicaid and Medicare depend on how a person qualifies. Medicaid income limits are state-specific, but certain federal Medicare limits can still enable dual ...