Topic
Prior Authorization
53 published works
Fennemore
Medicare and Cybersecurity Changes to Prepare for in 2027
By Fennemore
Practical priorities for providers and health plans Medicare changes taking effect in 2027 will reach well beyond the billing department. New requirements for electronic prior authorization, changes in health-plan payment…
Medicaid & Medicare: A Legal Blog
Two Days and Counting: What Medicare’s New Probationary Prior Authorization Means for DMEPOS Suppliers
Getting enrolled in Medicare has long been the main hurdle for a new supplier of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Starting October 15, 2026, newly enrolled suppliers…
Iowa Healthcare Law Blog
Brick Gentry P.C. Health Law June Update
This monthly update highlights key regulatory developments, enforcement trends, andcompliance issues affecting health care providers across the continuum – from solo practices to hospitals and large physician groups. Each section…
Agricultural Law & Rural Practice | Solo Small Firm & General Practice Section
What to Do When Your Prior Authorization Is Denied—And When to Call a Lawyer
Across the country, lawmakers are increasingly scrutinizing a health insurance practice that frustrates patients and doctors alike: prior authorization. A recent report by NPR highlights how states are stepping in…
Medicaid & Medicare: A Legal Blog
Is WISeR Really Wiser?
If anyone will be at HCCA’s regional conference next week in Alaska, I will be there speaking about e/m changes. Please come say hey if you are there. My presentation…
Med Law Blog
CMS Launches ASC Prior Authorization Demo for Certain “High-Risk” Procedures: What ASCs and Surgeons Need to Know
The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services for several years as part of its broader effort to…
Health Law Diagnosis
Massachusetts Governor Healey Announces New Department of Insurance Regulations Intended to Streamline Prior Authorization Practices
By Nathaniel Arden, Michael Lisitano
On January 14, 2026, Massachusetts Governor Maura Healey announced that the Division of Insurance (DOI) will be promulgating updates to its regulations with the intent of streamlining prior authorization practices…
Healthcare Law Blog
New WISeR Model Aims to Leverage AI Technology to Reduce Costs and Inefficiencies
By Margia Corner, Michael Sutton
The Centers for Medicare and Medicaid Services (“CMS”) recently announced the first six participating states in the Wasteful and Inappropriate Service Reduction (“WISeR”) Model that will begin on January 1,…
Health Industry Washington Watch
CMS Launches WISeR Model to Target Waste by Leveraging (Broken) Prior Authorization System
By Nancy Halstead, Sarah Cummings Stewart, Caitlin Chambers, Alexa Chronister
The Centers for Medicare & Medicaid Services (CMS) recently announced the launch of the Wasteful and Inappropriate Service Reduction (WISeR) Model – a six-year pilot program designed to reduce Medicare…
TCPA Blog
FCC Ends Quest to Amend its Definition of “Prior Consent” in the Wake of Eleventh Circuit Ruling
By Matthew M. Morrissey, Andrew C. Scarafile
On July 14, 2025, the FCC issued an Order halting a proposed amendment to 47 CFR § 64.1200(f)(9) that would have narrowed the scope of communications that may be sent…