The system is broken — and it must be fixed now.

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

Reforming prior authorization processes has been on the regulatory menu for a while. Both patients and providers have argued that prior ...

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

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 ...

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

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 ...

They often deny coverage via snail mail. Here’s what happened when my family got a note like that 36 hours before cancer surgery. By Ron Lieber Disease doesn’t ask permission before invading a body, ...

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 ...

Only one-third say that insurer efforts will make a real difference ...

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 ...