Health plans report an 11% drop in prior authorization volume as of April 7, 2026, following reform efforts, with continued focus on electronic processing and industry standardization.
CMS has delayed prior authorization requirements under the WISeR model for select radiology procedures following industry pushback, citing operational readiness concerns and ongoing AI-related scrutiny.
CMS proposes a new hospice scoring system and transparency measures in the FY 2027 rule to flag high-risk providers and strengthen oversight of Medicare hospice care.
CMS finalized a new rule requiring electronic claims attachments, with compliance required by May 2028 and significant projected cost savings.
CMS now requires payers to publicly report prior authorization denial rates, turnaround times, and appeal outcomes, with first reports due March 31.
HHS and CMS announce a new Healthcare Advisory Committee to guide policy, improve patient care, and modernize healthcare delivery across federal programs.
CMS Expands Claims Attachments Final Rule Webinar to Open Town Hall Format This Top Stories update highlights a recent CMS announcement expanding access to its
HHS proposes the HTI-5 rule to reduce Health IT certification requirements and reshape AI interoperability standards. The public comment period closed February 27, 2026, signaling upcoming regulatory changes.
OIG flags nursing home antipsychotic fraud, CMS weighs Medicare Advantage auto-enrollment, and MedPAC reports $76B in MA overpayments — March 22, 2026.
State Medicaid Budgets Will Decline by $665 Billion Under New Federal Law This Top Stories report summarizes a recent Stateline article outlining the projected $665
