CMS Pushes 24-Hour Drug Authorization Rule to Accelerate Patient Access
April 13, 2026
prior authorization
Prior Authorization Volume Drops by 11% as Payer Reform Efforts Take Hold
April 9, 2026
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 Delays Prior Authorization Expansion for Key Radiology Procedures
April 7, 2026
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 Hospice Scoring System to Flag High-Risk Providers
April 3, 2026
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 Claims Attachment Final Rule Announced in High-Demand Town Hall
March 31, 2026
CMS finalized a new rule requiring electronic claims attachments, with compliance required by May 2028 and significant projected cost savings.
Prior Authorization Denial Data Goes Public Under CMS Rule
March 31, 2026
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 New Healthcare Advisory Committee to Guide System Modernization
March 27, 2026
HHS and CMS announce a new Healthcare Advisory Committee to guide policy, improve patient care, and modernize healthcare delivery across federal programs.
CMS Expands Access to Claims Attachments Final Rule Webinar with Open Town Hall Format
March 26, 2026
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 HTI-5 Rule to Deregulate Health IT and Reshape AI Interoperability Standards
March 24, 2026
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.
March 22, 2026 Healthcare Policy Roundup
March 23, 2026
OIG flags nursing home antipsychotic fraud, CMS weighs Medicare Advantage auto-enrollment, and MedPAC reports $76B in MA overpayments — March 22, 2026.