The Centers for Medicare and Medicaid Services has announced a prior authorization program pilot for original Medicare. The six-year voluntary Wasteful and Inappropriate Service Reduction Model (WISeR ...

The letter to the CMS from Democrats is the latest salvo from lawmakers concerned that WISeR is delaying care to Medicare ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

The 2026 CMS Prior Authorization Final Rule is reshaping healthcare operations by shortening decision timelines, requiring specific denial reasons, and increasing transparency. Providers are turning ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

The Centers for Medicare & Medicaid Services announced a new Innovation Center model aimed at helping ensure people with Original Medicare receive care. Through the Wasteful and Inappropriate Service ...

Whether you’re filling a prescription or scheduling a procedure, chances are you’ve been asked whether you have prior authorization. By learning to navigate prior authorization and what steps to take ...

Medicare Advantage plans would have to respond to urgent prior authorization requests for medications within 24 hours, and standard requests within 72 hours, under a proposed rule from the Centers for ...

A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...