CMS is launching a six-year pilot of the WISeR Model, starting January 2026 in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington, which will use AI and human review to expand prior ...
On June 27, 2025, the Centers for Medicare & Medicaid Services (“CMS”), through its Innovation Center (“CMMI”), released the Request for Applications (“RFA”) for a new payment and service delivery ...
In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on ...
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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 Centers for Medicare & Medicaid Services (CMS) announced a new experimental model late last week to streamline some prior authorizations under the traditional Medicare program, but some ...
15don MSN
A new Medicare program that uses AI for prior authorizations is hurting patients and delaying care
Six states are part of a pilot program by CMS to reduce “waste, fraud and abuse.” ...
We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...
Senator Maria Cantwell has called on HHS to overhaul the Wasteful and Inappropriate Service Reduction (WISeR) Model.
The AHA Oct. 23 recommended changes to the CMS' Wasteful and Inappropriate Services Reduction model to address multiple concerns. The model is designed to use technology-enabled prior authorization to ...
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