Chandra is an emergency physician and global health policy specialist. Hoover is a former federal worker, sociobehavioral researcher, and global health technical specialist. We both lost our jobs as ...
Although the literature has investigated utilization management practices, how they align with clinical practice guidelines is not well understood. 10, 11 A better understanding of this alignment ...
The Centers for Medicare and Medicaid Services on Friday issued a 2026 Medicare Advantage and Part D final rule that makes changes to authorization decisions. One provision restricts a plan's ability ...
Starting in January, Medicare will test out an artificial intelligence (AI) pilot program to decide whether patients get certain procedures covered or not. The Centers for Medicare & Medicaid Services ...
Panelists discuss how integrating real-world evidence into coverage frameworks can enhance decision-making and align payer policies with actual patient outcomes. Panelists discuss how real-world ...
First blood-only liquid biopsy test for molecular residual disease testing now covered for certain fee-for-service Medicare patients in US with stage II or III colorectal cancer PALO ALTO, ...
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