The Center for Medicare and Medicaid Innovation (CMS) has officially announced which producers will require prior ...

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 ...

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

The Centers for Medicare and Medicaid Services has announced a prior authorization program pilot for original Medicare. The six-year voluntary Wasteful and Inappropriate Service Reduction Model (WISeR ...

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

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining in prior authorizations -- remains on both parties' radar screens, ...

Democrats are raising concerns about a new CMS pilot program testing prior authorization requirements, which make patients get their health plan’s approval before receiving certain services, in ...

A CMS pilot program that would add prior authorization for some traditional fee-for-service Medicare services has come under increased scrutiny by some members of Congress, including a call to pause ...

61% — The percentage of physicians who said that patients frequently abandon a recommended treatment due to prior authorizations in Medscape’s “They’re Awful and Impede Patient Care: Medscape ...

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 ...