A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

In August, AHIP, the trade association for health insurance companies representing the industry’s top players, announced that they reached a deal with the White House to reform prior authorization for ...

Participating health plans have signaled that they're implementing common, transparent submissions for electronic prior authorization. This commitment includes the development of standardized data and ...

Christopher Marks noticed an immediate improvement when his doctor prescribed him the Type 2 diabetes medication Mounjaro last year. The 40-year-old truck driver from Kansas City, Missouri, said his ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

Nearly seven months after the fatal shooting of an insurance CEO in New York drew widespread attention to health insurers’ practice of denying or delaying doctor-ordered care, the largest U.S.

Prior authorization — in which a patient needs approval from the health plan before proceeding with a medical service — has long created a rift between payers and providers. It has gotten such a bad ...

An insurance company often requires this type of preapproval for certain services, procedures, prescription medications, and medical supplies. Your healthcare team can often help you navigate this ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications. UnitedHealthcare, CVS Health’s Aetna and dozens of ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

Prior authorization companies are moving into ambient listening, while ambient listening companies are expanding into prior authorization — a trend underscored by yet another partnership bridging the ...

A new North Dakota law that took effect January 1 makes it so health insurers must respond to prior authorization requests in a timely fashion. The changes follow reforms seen elsewhere in the country ...