Government-backed plans like Medicare, however, have tended to cover what private insurers don't, and without the laborious application process. But that could be poised to change. The Centers for Medicare and Medicaid Services said it'll experiment with its own version of prior authorization by using AI models to screen claims, as part of its new belt-tightening program called the Wasteful and Inappropriate Service Reduction model, or WISeR.
On Tuesday morning in Searsport, Maine, Republican Sen. Susan Collins woke up and decided to do something she very, very rarely does: hold a public press event in her state. The event was in celebration of the completion of two years of construction and renovation on the town's Main Street-though very few people were feeling celebratory. Over 200 protesters showed up to the ribbon-cutting ceremony to express their dismay at the senator, her voting record, and the Trump administration at large.
"There's a lot the state can do-they certainly should not be exacerbating the federal impacts," Williams said. "The most recent budget adopted by the state layers its own medical cuts on top of federal cuts, and that is very concerning. The state needs to take care of its public hospital systems."
CMS proposed a 2.4% increase in Medicare payments for hospital outpatient services and ambulatory surgery centers, reflecting a market basket update and productivity adjustment.
"Policymakers should create evidence-based, condition-specific remote monitoring duration limits and require an active redetermination of medical necessity to continue coverage for these services beyond those limits."
