Over 6 million Americans on Medicare will now need to get prior authorization from AI for these 17 procedures

A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.
Pharm Exec

Empowering Prior Authorization Professionals

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...
MedPage Today on MSN

Medicare Is of Two Minds on Prior Authorization

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...
Forbes

Do You Know If Your Medicare Advantage Plan Requires Prior Authorization?

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 ...
Healio

Q&A: Prior authorization limits, delays options in allergy, asthma care

Please provide your email address to receive an email when new articles are posted on . Most medications in allergy and asthma care require prior authorization. Providers should screen for failed ...
Healthcare Dive

CMS finalizes rule tightening prior authorization turnaround for insurers

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...
NPR

How prior insurance authorization affects physicians and the care they give patients

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 ...
The New York Times

The Health Insurance Prior Authorization Memo That You Helped Write

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...
STAT

True peer-to-peer conversations will improve prior authorization

It’s another busy day in my spine surgery clinic when my phone rings. Patients are waiting, but I’d be unwise to put off the caller: a physician calling from a health insurance company. This ...
Healthcare Dive

UnitedHealthcare cuts back prior authorization requirements

UnitedHealthcare, the largest private payer in the U.S., plans to eliminate almost 20% of its current prior authorizations starting this summer, the company announced Wednesday. The decision, which ...
CNN

Insurers promised to ease a major patient pain point after executive’s murder. Here’s what’s happened

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...