The Centers for Medicare & Medicaid Services is attempting to cover anti-obesity medications under Medicare Part D and ...

The Centers for Medicare & Medicaid Services (CMS) is proposing new limits on Medicare Advantage (MA) plans regarding prior authorization, utilization ...

Federal officials announced Tuesday that audits they launched earlier this year have led to significant new reforms.

In November 2024, the Department of Health and Human Services Office of Inspector General (OIG) published the results of its ...

Arguing that Medicare Advantage ... The lawmakers said CMS should conduct greater oversight of plans “inventing new strategies” such as concurrent reviews, pre-payment audits, payment reviews ...

The Sunshine Act, established under the Affordable Care Act, mandates that manufacturers of drugs, biologics, medical devices ...

The legislature’s constitutional power of the purse has degenerated from a tool of responsible governance into an instrument ...

America's greatness lies not in perfection but in her relentless pursuit of it. For nearly 250 years, this nation has strived ...

Insurance companies have to pay for PrEP under federal rules, but some skirt the requirement for free access to the treatment ...

The Centers for Medicare & Medicaid Services (CMS) is taking new steps to improve Medicare Advantage (MA) access and ...

The integration of generative AI with CQL can allow healthcare providers to leverage AI without needing extensive technical ...

A recent OIG report found that diagnoses reported in 2022 Medicare Advantage ... from initial and annual HRAs. CMS encourages providers to use HRAs as a tool to collect information from enrollees ...