American Enterprise Institute

Prior Authorization Reduces Net Costs of Medicare Part D

Administrative costs are estimated to make up between 20 and 34 percent of US health care expenditures, roughly 1–4 percent of GDP. Academic and policy discussions generally characterize these costs ...
California Healthline

Prior Authorization Requirements of Medicare Drug Benefit Examined

The New York Times on Tuesday examined how some physicians and pharmacists maintain that many medications covered by Medicare prescription drug plans are "not readily available" to beneficiaries ...
Becker's Hospital Review

CVS Health cuts prior authorizations, expands rebate sharing

CVS Health cuts prior authorizations, speeding approvals and expanding biosimilar use to reduce costs and improve patient access.
Tennessean

Insurers try not to deny patients prescription drugs. Here's how prior authorization works

Natalie Tate, PharmD, is vice president of pharmacy at BlueCross BlueShield of Tennessee. Nationwide, prescription drugs are the costliest and commonly used heath plan benefit. Last year, BlueCross ...
Healthcare Finance News

Optum Rx announces a reduction in drug prior authorization

Optum Rx has announced it will drop prior authorization for an estimated 80 drugs starting May 1. The program targets reauthorizations of drugs. For instance, once a genetic condition such as cystic ...
Becker's Hospital Review

From hours to minutes: AI transforms MetroHealth’s pharmacy prior authorization process

Cleveland-based MetroHealth has improved the speed and success of its medication prior authorization process with the help of AI, cutting submission times from 18 hours to around five minutes and ...

Gov. Maura Healey unveils insurance reforms to speed access to health care

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...
The American Journal of Managed Care

Study Finds Prior Authorization Mandates for PCSK9 Drugs Raise Questions of Access

Researchers were especially concerned about barriers for patients with familial hypercholesterolemia, whose needs would seem clear cut but who nonetheless faced costly hurdles, such as genetic testing ...
TCTMD

Maze of Prior Authorization for PCSK9 Inhibitors Poses Challenge to Prescribers

Prior authorization requirements for PCSK9 inhibitor prescriptions are more cumbersome than those in place for other cardiometabolic drugs, a new study demonstrates. The complex processes are seen for ...
Healio

Prior authorization requirements substantial for PCSK9 inhibitors

Please provide your email address to receive an email when new articles are posted on . PCSK9 inhibitors required more prior authorization requirements compared with other drugs for cardiometabolic ...
Morningstar

SamaCare Celebrates One Million Medical Benefit Drug Prior Authorizations, Made Fast, Easy, and Accurate with AI

SAN FRANCISCO, June 12, 2025 /PRNewswire/ -- SamaCare, a cloud-based patient access platform for specialty medications, today announced that it has passed the 1MM milestone in prior authorizations ...