Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...

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 ...

Health insurance companies across the country have agreed to streamline and simplify the prior authorization process for patients seeking certain medical treatment, according to a nationwide industry ...

AI-powered prior authorization in Medicare Advantage and private insurance has attracted intense criticism, legislative action by state and federal lawmakers, federal investigations and class-action ...

The American Medical Association (AMA) and a bipartisan group of Congressional leaders are looking to stop unfair prior authorization practices from health plans. Introduced by Rep. Suzan DelBene ...

Forbes contributors publish independent expert analyses and insights. Bob Carlson researches all facets of retirement finances. There were two major announcements recently regarding prior approval of ...

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

People walk inside a Medicare Services office in New York City. Reporter Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid ...

Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences. Many states have adopted or are ...

Kodiak Solutions said in a May 21 report that if payers used consistent criteria for making prior authorization/preficiation claim denials, the denial rates would be ...