Medicare

Medicare Tests AI Prior Authorization in Six States

Medicare Tests AI Prior Authorization in Six States
Medicare Tests AI Prior Authorization in Six States
June 25, 2026  |  Artificial Intelligence

The Centers for Medicare & Medicaid Services (CMS) launched the WISeR Model in January, short for Wasteful and Inappropriate Service Reduction Model, with the aim...

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Medicare Tests Algorithms to Streamline Prior Authorization
Medicare Tests Algorithms to Streamline Prior Authorization
September 25, 2025  |  Artificial Intelligence

Medicare is set to bring artificial intelligence (AI) into the core of its decision-making, testing whether algorithms can determine which treatments get covered in the...

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This Healthcare CEO Has a New Prescription for Pediatric Care
This Healthcare CEO Has a New Prescription for Pediatric Care
March 04, 2025  |  Healthcare

In a healthcare landscape often dominated by discussions of senior care and chronic disease management, innovation is increasingly turning the spotlight to an often overlooked...

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Musk’s DOGE Reportedly Digging Into Medicare Payment System
Musk’s DOGE Reportedly Digging Into Medicare Payment System
February 05, 2025  |  Legal & Regulation

Elon Musk’s Department of Government Efficiency (DOGE) has reportedly gained access to Medicare’s payment system. Representatives from the newly-created department have been working at the Centers...

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WEX Introduces Digital Commerce Solution for Medicare Platform
WEX Introduces Digital Commerce Solution for Medicare Platform
November 21, 2024  |  eCommerce

Global commerce platform WEX added a digital shopping solution to its Medicare Advantage supplemental benefits platform. The Medicare Advantage marketplace expands the brick-and-mortar merchant network...

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Regulators Warn Against Improper Billing of Medicare Recipients
Regulators Warn Against Improper Billing of Medicare Recipients
November 01, 2024  |  Legal & Regulation

Two federal agencies warned healthcare providers, Medicare Advantage plans and debt collectors not to improperly bill Qualified Medicare Beneficiary recipients (QMBs), who generally cannot be...

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GoHealth to Acquire e-TeleQuote to Expand Health Insurance Marketplace
GoHealth to Acquire e-TeleQuote to Expand Health Insurance Marketplace
September 04, 2024  |  Partnerships

Health insurance marketplace GoHealth has inked an agreement to buy Medicare-focused e-TeleQuote. The acquisition is expected to close Sept. 30, GoHealth said in a Wednesday...

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Amazon Expands Prescription Offering to Medicare Members
Amazon Expands Prescription Offering to Medicare Members
June 18, 2024  |  Retail

Amazon said it has expanded its prescription drug program to include Medicare beneficiaries. Beginning Tuesday (June 18), more than 50 million enrollees in the government...

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