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

A new AI tool is being tested in Oklahoma to process prior authorizations in Medicare. These Oklahomans say they're worried.

State insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements for “many ...

The Centers for Medicare and Medicaid Services (CMS) is poised to launch a bold, new initiative to reduce waste, fraud and abuse. Starting January 1, 2026, the Wasteful and Inappropriate Service ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

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 ...

While the headaches and life-altering results of insurance pre-authorizations are not new to physicians or patients, lately things have been getting worse. Patients are sending more and more messages ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

Surescripts®, the nation's leading health intelligence network, today announced a major expansion of its Touchless Prior Authorization technology, now reaching more than 76,000 prescribers across the ...

Prior authorization companies are moving into ambient listening, while ambient listening companies are expanding into prior authorization — a trend underscored by yet another partnership bridging the ...

Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many older adults choose original Medicare ...