2+ day, 1+ hour ago   (367+ words) KFF analyzed new federal prior authorization data and found significant variation in how insurers handle requests across Medicare Advantage, Medicaid, and the ACA markets. The CMS issued a final rule in 2024 aimed at streamlining prior authorization processes for insurers. Although…...

2+ day, 3+ hour ago   (405+ words) The CPT codes provide a standardized way to talk about and bill for medical services, and are deeply ingrained into U.S. healthcare — including in the government, which uses the CPT system to code for healthcare services and procedures in federal programs....

2+ day, 3+ hour ago   (360+ words) Healthcare Dive Don't miss tomorrow's healthcare industry news Premiums, out-of-pocket costs dominate Americans’ healthcare concerns: survey Respondents were split on who should solve the issues, with Democrats more likely to say the federal government and Republicans more likely to name…...

3+ day, 1+ hour ago   (646+ words) The appeals court ruled Tuesday that insurers can’t include ghost rates or exclude bonus payments in calculating a key metric used to determine provider reimbursement for out-of-network bills. The ruling is another setback for insurers as they jockey with providers…...

3+ day, 1+ hour ago   (353+ words) Advanced AI models have fundamentally changed healthcare’s cyber threat landscape. CHAI’s new work group aims to help organizations navigate this new reality. CHAI, which regularly produces frameworks for the responsible use of health AI, said it convened the new work…...

3+ day, 3+ hour ago   (347+ words) Medicare and Medicaid funding cuts are predicted to worsen existing workforce gaps, particularly in rural and underserved areas, a new report shows. The workforce shortage won’t self-correct — more physicians are retiring, medical school costs are rising and demand for specialists…...

3+ day, 23+ hour ago   (919+ words) The agency is being accused of fudging the data on how many people will lose Medicaid and how much the government will save as a result of the rule. Medicaid beneficiaries will start working in droves. Few sick Americans will…...

4+ day, 52+ min ago   (254+ words) The CMS rule eliminates federal funding for services like puberty blockers and surgeries for minors, though states can still cover the services with their own dollars. Medicaid and CHIP funding will remain available for up to six months after Oct....

4+ day, 3+ hour ago   (635+ words) The libertarian think tank analyzed almost 130 studies digging into the controversial laws, which require providers to get state approval before building facilities or adding new services. Certificate of need laws, which require providers to get state approval before they build…...

4+ day, 4+ hour ago   (180+ words) First announced last fall, the portal leverages foundation models from OpenAI to help patients navigate their medical records. Users can use the patient portal to review their medical records, engage with providers, schedule appointments, and ask questions to receive AI-generated…...