The proposed rule aims to improve prior authorization for prescription drugs by establishing and requiring electronic prior ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement ...

The days of faxed forms and days-long waits for prior authorization approvals are officially ending under the new CMS 2026 rules. With the Interoperability and Prior Authorization Final Rule now in ...

Dozens of health insurers have made a series of commitments to improve and reduce prior authorization, payer advocacy organization AHIP announced on Monday. The practice is often a point of contention ...

Major policy shift: UnitedHealthcare will drop prior authorization for 30% of currently restricted services, including some surgeries, diagnostic tests, and therapies. Industry-wide reform: The change ...

Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: ...