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Medicare › Regulatory Requirements › Insurance Claims

Mintz - Health Care Viewpoints

WISeR Model Will Test the Use of Artificial Intelligence for Prior Authorization in Medicare: Key Considerations for Health Care...

Mintz - Health Care Viewpoints on

The Center for Medicare and Medicaid Innovation (CMMI) recently announced a six-year payment model for 2026-2031 called the Wasteful and Inappropriate Service Reduction (WISeR) Model. WISeR will test the use of artificial...more

Dentons

Ep. 59 – Treating Medicare Beneficiaries as a Cash-Based Practice

Dentons on

Cash-based practices, or providers who neither participate with nor bill insurers, are becoming increasingly common, especially in certain specialties such as primary care, women’s health, and mental health. While providers...more

Laughlin, Falbo, Levy & Moresi LLP

A NEW MEDIC-ERA; Changes to CMS Review Guidelines in 2025

Laughlin, Falbo, Levy & Moresi LLP on

Vast changes are swiftly approaching regarding the efforts Workers’ Compensation practitioners must make in protecting Medicare’s interests in future medical settlements. The Centers for Medicare/Medicaid Services (CMS) has...more

Chartwell Law

Two Major Updates to Pennsylvania Medicare Set-Aside Rules

Chartwell Law on

The Centers for Medicare & Medicaid Services (CMS) recently announced two significant updates to Workers’ Compensation Medicare Set-Aside (WCMSA) rules, effective in 2025. These changes affect $0 MSA proposals and immediate...more

Goldberg Segalla

CMS Issues Alert & WCMSA User Guide Update; Positive Changes Expedite Allocation Practice

Goldberg Segalla on

Beginning April 7, the Centers for Medicare & Medicaid Services (CMS) will eliminate its one-year waiting period for Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Amended Review requests. Instead, CMS will...more

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