GoodRx reports that starting January 2026, original Medicare will require prior authorization for certain services in six ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

Ohio is one of six states testing an AI-led prior authorization program for around a dozen medical procedures for patients ...

Navigating the healthcare system can be a complex and frustrating experience for many patients. Among the many challenges, one of the most insidious barriers to timely care is prior authorization.

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...

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.

Prior authorization denials in Medicare Advantage (MA) jumped between 2021 and 2022, according to a new analysis from KFF. Researchers dived into data from the Centers for Medicare & Medicaid Services ...

One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

CLEVELAND, Ohio — A new Medicare pilot program set to launch next year in Ohio and other states could change the way older Americans access certain medical treatments, drawing sharp criticism from ...