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

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 ...

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

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

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 ...

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 ...

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 ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...