In 2023, there were nearly two prior-authorization determinations per Medicare Advantage enrollee, on average, compared with about one prior-authorization review submitted per 100 traditional Medicare ...

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use of prior authorization in Medicare. On the one hand, there is the effort ...

Please provide your email address to receive an email when new articles are posted on . Most medications in allergy and asthma care require prior authorization. Providers should screen for failed ...

Dozens of health insurers have made a series of commitments to improve and reduce prior authorization, payer advocacy organization AHIP announced on Monday. The practice is often a point of contention ...

Insurance companies often make doctors ask their permission before treating patients. This template can help medical professionals explain how it works. By Ron Lieber Ron Lieber will update this ...

Many physicians believe prior authorization gets in the way of sound patient care. New reforms from the insurance industry aim to address these challenges. Will they make a difference? You learn a lot ...

Insurers designate certain prescription drugs with prior authorization to ensure safe and medically appropriate use but also to contain costs. Here, a healthcare provider must obtain approval from a ...

Under a final rule released today, impacted payers will be required to send prior authorization decisions within 72 hours for urgent requests and seven calendar days for standard requests. The Centers ...

Dear Secretary Kennedy and Administrator Oz: On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 ...