Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service ...

New Medicaid prior-authorization rules have advocates in Connecticut concerned about patients losing access to their prescription drugs.

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

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 ...

June 23 (UPI) --Major American insurers announced Monday that they have agreed to speed up and smooth out the processes involved with the reception and administration of health care by streamlining ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

Prior authorization (PA) is a widely used insurance mechanism intended to ensure cost-effective, evidence-based care. However, in practice, it often imposes significant administrative and clinical ...

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 ...

Aetna provided an update on its efforts to streamline the healthcare experience on Thursday, one year to the day after the fatal shooting of UnitedHealth’s top insurance executive sparked a wave of ...

Prior authorization is no longer just an administrative hurdle for ASCs; it is a defining constraint on growth. As authorization requirements expand, policies shift and payer scrutiny intensifies, ...