The push to revamp prior authorization practices has picked up steam recently. Some physicians and other healthcare leaders have long been outspoken about the issues created by strict prior ...

Ask a provider what’s causing tension in their relationship with insurers and many will point to prior authorization, arguing that the practice creates administrative burdens and delays in patient ...

Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...

Here are 10 things for ASCs to know regarding prior authorization in 2024: 1. CMS updated its interoperability and prior authorization final rule at the beginning of the year. The rule requires payers ...

While progress at the federal level is slow, state legislatures are passing bills aimed at improving the prior authorizations process for healthcare providers. State legislatures are taking action to ...

Medicare beneficiaries in 10 states will soon be participating in a new prior authorization program. The Centers for Medicare & Medicaid Services (CMS) is implementing a five-year demonstration ...

Add Yahoo as a preferred source to see more of our stories on Google. In June of this year, CMS announced that it would be launching the Wasteful and Inappropriate Service Reduction (WISeR) Model, ...

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

Health and Law flat lay. Judge gavel, medicine and doctor coat on blue, background, top view. Medical malpractice, personal injury attorney. Prior authorization has caused significant frustration for ...

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 ...