There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor ...

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 ...

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

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 ...

Many private health insurers require medical providers to get approval before administering treatment, sometimes resulting in delayed or denied care for patients. Now, that tactic, known as prior ...

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

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 ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

Please provide your email address to receive an email when new articles are posted on . Physicians reported that prior authorizations diverted time, increased health care utilization and delayed care.

Last week CMS issued its final rule “CMS Interoperability and Prior Authorization” (CMS-0057-F), unchanged from its proposed rule in 2022, which addresses prior authorizations. Prior authorization, a ...