The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

The federal government has begun using artificial intelligence to review whether certain treatments are necessary for ...

The new KFF report found that payers either fully or partially denied 4.1 million prior authorization requests in 2024, or ...

The rule is expected to reduce staff workload, with fewer manual processes, and better visibility into coverage requirements and authorization status.

The paperwork burden of prior authorization keeps climbing, and for some ASCs, the only way through is to treat it like a daily fight. Elisa Auguste, administrator at East Setauket, N.Y.-based ...

CVS Health cuts prior authorizations, speeding approvals and expanding biosimilar use to reduce costs and improve patient access.

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

CVS Health (CVS) on Thursday announced that it plans to make a large portion of its prior authorization procedures consistent ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...

The House Banking and Insurance Committee advanced a bill on Wednesday, Jan. 14 that would allow certain health care ...

Staff at Arkansas' Harmony Park Family Medicine have been excited about streamlining the prior authorization process with the goal of improving patient access to high-quality care. Prior authorization ...

Payer updates and policy changes delay reimbursement; Leaders say automated solutions can help fight back. The tug-of-war between providers and payers over prior authorizations is a consistent and ...