CMS releases guide on prior authorization submissions, determinations under WISeR model
The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and Inappropriate Service Reduction model. It provides an overview of the prior authorization submissions and determinations procedures and details the pre-payment medical review processes for services delivered in states where the WISeR model is being implemented: New Jersey, Ohio, Oklahoma, Texas, Arizona and Washington.
Related News Articles
Headline
UnitedHealth Group announced Jan. 14 that it launched a six-month pilot program to reduce Medicare Advantage payment processing times by half for rural…
Headline
A Senate Judiciary Committee report released Jan. 12 found that UnitedHealth Group used “aggressive strategies” to maximize its Medicare Advantage risk-…
Headline
The Centers for Medicare & Medicaid Services has released a request for information seeking input on replacing its Medicare claims processing system with a…
Headline
The AHA Jan. 9 urged the Medicare Payment Advisory Commission to consider, during its next meeting Jan. 15-16, higher payment updates for the…
Headline
The 1st U.S. Circuit Court of Appeals Jan. 7 denied the government’s motion for a stay in a lawsuit filed by the AHA, the Maine Hospital Association and four…
Headline
The application period has opened for hospitals to apply for the latest allocation of Medicare-funded graduate medical education residency slots under Section…