While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the ...

Clinical practice in the United States is marked by significant variation, leading in some cases to suboptimal quality of care and poor health outcomes. Despite the proliferation of clinical practice ...