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Payers, providers applaud new CMS prior authorization rule

Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient

CMS releases Advancing Interoperability and Improving Prior Authorization Processes Proposed Rule

In a newly proposed rule, the Centers for Medicare and Medicaid Services is changing prior authorization standards to speed up the time it takes for payers to approve the requests and is implementing HL7 FHIR standards to support an electronic process. CMS is proposing to require certain payers, including Medicare Advantage organizations, to implement electronic prior

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