The Centers for Medicare & Medicaid Services (CMS) will use AI to help make prior authorization decisions via the new Wasteful and Inappropriate Service Reduction (WISeR) Model, but the final decision ...

The procedures will be reviewed by AI for coverage determinations, although final decisions will be made by people. The companies contracting to do the review process will receive payments when they ...

Weiss Memorial Hospital will be kicked off Medicare and Medicaid programs, and a report suggests it could face closure when ...

The president posted talking points provided by one firm that donated millions, and his administration delayed a change on ...

UnitedHealthcare says it plans to drop Medicare Advantage plans that currently serve over 600,000 users, becoming the latest ...

Resilience Healthcare acquired both Weiss and West Suburban Medical Center out of bankruptcy in 2022. Both facilities depend ...

Click in for more news from The Hill{beacon} Health Care Health Care   The Big Story Pharma industry loses on Medicare price ...

Medicare beneficiaries would receive a no-cost falls risk assessment from a physical or occupational therapist under a new bill.

Insurers plan to keep sacrificing MA growth for profitability next year, after second quarter results for Humana and CVS ...

Federal judges in Texas and Connecticut on Thursday ruled against arguments challenging the constitutionality of the Medicare ...

The emergency room and other facilities closed as of 7 a.m. Friday, emergency room registered nurse Daniel Maser said.

An Allentown pharmacy and its owner will pay $825,000 to the federal government to resolve allegations that the pharmacy ...