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

The Centers for Medicare and Medicaid Services (CMS) is adding electronic prior authorization to the Health Tech Ecosystem, ...

The planned cuts come as payers face ongoing pressure to reduce prior authorization use. For example, a recent initiative led ...

The influential advisory group is recommending policies to boost human oversight and visibility into how Medicaid plans are ...

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 ...

Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...

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 ...

The Centers for Medicare & Medicaid Services (CMS) has proposed extending its electronic prior authorization requirements to include prescription drugs starting in 2026. The rule would require ...

With denial rates at 4 percent in 2025, the Dallas-based, tech-forward insurer is outperforming national averages.

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 ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...