These health care hurdles can stand in the way of getting treatment your doctor says you need. Here’s what to know about how ...

Submit an appeal, even if you’re worried you’ll lose. Yaver said that, based on the research set to be published in her book, Coverage Denied: How Health Insurers Drive Inequality in the United States ...

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 ...

NPR's Michel Martin speaks with American Medical Association President Bruce Scott about how physicians and patients are burdened by insurance companies' systems of prior authorization. A lot has been ...

Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...

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 ...

Use of prior authorization in the Medicare Advantage (MA) program continues to increase, according to a report from KFF. More than 46 million prior authorization requests were submitted to Medicare ...

If there’s one thing healthcare providers can agree on, it’s that prior authorization management is a heavy administrative burden and only growing heavier. Decades ago, it was created to ensure care ...

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 ...

The push toward healthcare interoperability and electronic prior authorization is meant to ultimately benefit patients and providers. However, providers will have to navigate these changes and ...

Health insurers are cautioning that prior authorization reforms could worsen health care cost increases, but a stream of doctors say the current system is plagued by administrative burdens and ...