In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

As providers keep hearing over and over-from RACs and their own Medicare contractors, insufficient documentation is frequently the reason for claim denials. Whether these denials come up front from ...

Inconsistent Medicare Part B local coverage determinations (LCDs) create disparities in Medicare beneficiary access to items and services, a recent OIG report concludes. The OIG focused on LCDs issued ...

Organogenesis (ORGO) and MiMedx (MDXG) traded lower on Friday after the Centers for Medicare & Medicaid Services (CMS) announced the withdrawal of final Local Coverage Determinations (LCDs) related to ...

The U.S. Centers for Medicare & Medicaid Services announced that several Medicare administrative contractors have formally withdrawn local coverage determinations for skin substitutes. There are ...