Prior Authorization and Pre-Claim Review Initiatives | CMS
Sep 15, 2025 · CMS runs a variety of programs that support efforts to safeguard beneficiaries’ access to medically necessary items and services while reducing improper Medicare billing …
New Medicare program: Full list of services that will need prior approval
4 days ago · Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial intelligence tools.
New Medicare Changes in 2026: Prior Approval Required for …
Aug 27, 2025 · Beginning January 1, 2026, certain medical procedures under Traditional Medicare will require prior authorization in six U.S. states. This means your healthcare …
Welcome to Medicare | Medicare
From January 1 – March 31, if you’re in a Medicare Advantage Plan, you can switch plans or return to Original Medicare and join a separate Medicare drug plan. You can also add your …
Prior Authorization Coming to Traditional Medicare Starting in 2026
The Centers for Medicare and Medicaid Services (CMS) will implement prior authorization requirements for certain traditional fee-for-service Medicare services in six states starting next …
Does Medicare Require Prior Authorization? | U.S. News
Aug 11, 2025 · Learn about when and why prior authorizations are needed, which services require them and how they are used differently between original Medicare and Medicare …
Medicare Prior Authorization - Center for Medicare Advocacy
Prior authorization is a requirement that a health care provider obtain approval from Medicare to provide a given service. Prior Authorization is about cost-savings, not care.
How Medicare Prior Authorization Rules Are Changing in 2026
Aug 18, 2025 · Before certain services or medications can be provided, healthcare providers must obtain approval from Medicare or a Medicare Advantage plan. This ensures that care is …
Medicare's New Prior Approval Pilot—What You Need to Know
Aug 29, 2025 · The initiative, announced by the CMS in June, will require recipients of Original Medicare to receive prior approval before obtaining access to certain medical services.
Medicare Pre-Authorization: When Is It Required and How It …
Dec 18, 2025 · Does Medicare require pre-authorization? Learn when Medicare and Medicare Advantage plans require prior authorization and how to appeal denied claims.