Search results for Medicare 72-Hour Decision Rule

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savingadvice.com /2 weeks ago

Medicare’s 72-Hour Decision Rule Begins Now: What Seniors Must Know About Faster Approvals and Denials

Millions of seniors enrolled in Medicare Advantage plans have spent years frustrated by delayed prior authorization decisions for medical care, scans, procedures, and treatments. S...

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natlawreview.com /3 weeks ago

Proposed Medicare Payment Policy Changes for Hospitals and Long-Term Care Hospitals

The Centers for Medicare & Medicaid Services (“CMS”) recently published its proposed payment rules for general acute care hospital inpatient services and long-term care hospita...

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natlawreview.com /1 month ago

The 36-Month Rule Comes to DMEPOS: What Suppliers Need to Know

Two recent regulatory actions by the Centers for Medicare & Medicaid Services (CMS) have reshaped the ownership and enrollment landscape for Durable Medical Equipment, Prosthet...

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aha.org /1 month ago

CMS proposes hospice payments for FY 2027; increased oversight and reporting

The Centers for Medicare &amp; Medicaid Services April 2 issued a proposed rule that would update hospice payment rates for fiscal year 2027. Overall, CMS proposes a 2.4% net i...

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aha.org /1 month ago

CMS issues hospital IPPS proposed rule for FY 2027

The Centers for Medicare &amp; Medicaid Services April 10 issued a proposed rule that would increase Medicare inpatient prospective payment system rates by a net 2.4% in fiscal...

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savingadvice.com /1 month ago

Medicare Advantage Prior‑Authorization Denials Jumped 56% — New April Rules Aim to Fix It

If you’ve ever had a doctor recommend a treatment—only to be told you need “approval first”—you’ve experienced prior authorization. For millions of seniors on Medicare...

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fiercehealthcare.com /1 month ago

AI-powered prior authorizations for Medicare have greatly delayed care, Washington state hospitals say

The Centers for Medicare & Medicaid Services' experimental WISeR Model has Medicare patients waiting two to four times longer for procedures, according to a Washington senators...

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natlawreview.com /1 month ago

CMS Releases FY 2027 IPPS Proposed Update

On April 10, 2026, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule. This proposed...

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fiercehealthcare.com /1 month ago

Proposed CMS rule would set prior auth deadlines for drugs

The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for pharmaceuticals.

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savingadvice.com /1 week ago

The Medicare ‘Observation Status’ Problem: Why Some Seniors Are Still Receiving Unexpected Rehab Bills in 2026

Many seniors assume that if they spend several nights in a hospital bed, Medicare will automatically cover any rehab care they need afterward. Unfortunately, thousands...

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aha.org /1 month ago

CMS releases FY 2027 proposed rule for long-term care hospitals

The Centers for Medicare &amp; Medicaid Services April 10 proposed increasing the&nbsp;long-term care hospital&nbsp;standard rate payments by 2.4% in fiscal year 2027&a...

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aha.org /1 month ago

CMS releases proposed rule establishing electronic standards for drug prior authorizations

The Centers for Medicare &amp; Medicaid Services April 10 released a proposed rule that would establish electronic standards for drug prior authorizations. Building on a 2024 f...

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hallrender.com /1 month ago

CMS Releases FFY 2027 IPPS Proposed Rule; Wage Index Deadlines

The FFY 2027 IPPS Proposed Rule (“Proposed Rule”) was released on April 10, 2026, and CMS published the associated tables on its Proposed Rule homepage. The Proposed Rule is expect...

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aha.org /1 month ago

CMS finalizes policy and technical changes to Medicare, MA, Part D for CY 2027

The Centers for Medicare &amp; Medicaid Services April 2 released a final rule on policy and technical changes to Medicare Advantage, the Medicare Prescription Drug Benefit Pro...

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aha.org /1 month ago

Protecting Access to Care for Our Most Severely Ill Patients

Few patient populations are more vulnerable to the shifting winds around health care today than Medicare beneficiaries who need specialized, high-acuity and long-stay care.The Esse...

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natlawreview.com /1 month ago

CMS Proposes Major Changes to Drug Prior Authorization Processes: What You Need to Know

On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule[1] that would require faster prior authorization (“PA”) decisions, expand electr...

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natlawreview.com /4 weeks ago

CMS Issues a Proposed Rule Impacting Quality Reporting, Care Compare and MDS Requirements for Skilled Nursing Facilities

Key Takeaways: CMS has proposed FY 2027 SNF PPS updates, including a 2.4% payment increase and changes to quality reporting and data submission. The proposal also removes certain...

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aha.org /1 month ago

CMS proposes 2.8% payment update for IRFs for FY 2027

The Centers for Medicare &amp; Medicaid Services April 2 released the fiscal year 2027 prospective payment system proposed rule for inpatient rehabilitation facilities. The rul...

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savingadvice.com /1 month ago

The Medicare Rule Change Causing Confusion in 6 States — Here’s What It Really Means

If you’ve heard that a new Medicare rule is “changing how care gets approved,” you’re not alone—and you’re not imagining the confusion. In 2026, a...

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natlawreview.com /2 weeks ago

Moratorium on New Medicare Enrollment

CMS is imposing a six-month nationwide moratorium on new Medicare enrollment for hospices and home health agencies in a sweeping effort to combat fraud. Effective immediately, CMS...

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aha.org /1 month ago

CMS, FDA announce pathway to expedite access to certain medical devices for Medicare beneficiaries

The Centers for Medicare &amp; Medicaid Services and the Food and Drug Administration April 23 announced a new pathway to expedite access to certain FDA-designated Class II and...

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savingadvice.com /1 week ago

CMS’s New AI-Powered Prior Authorization System: Will It Speed Up Approvals or Deny Seniors Critical Care?

For years, seniors and doctors have complained that prior authorization delays can feel like a second illness layered on top of an existing medical problem....

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bioengineer.org /2 days ago

Hospital Admissions from 72-Hour ER Returns in Elderly

In a groundbreaking new study poised to redefine geriatric emergency care protocols, researchers have explored the critical outcomes associated with emergency department (ED) retur...

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jdsupra.com /1 month ago

CMS and FDA Announce RAPID Coverage Pathway to Accelerate Medicare Coverage for Breakthrough Medical Devices

Key Takeaways: Faster Medicare Coverage. The Centers for Medicare & Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA) have announced the Regulatory Alig...

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