A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

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 ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...

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 ...

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 ...

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...

It’s another busy day in my spine surgery clinic when my phone rings. Patients are waiting, but I’d be unwise to put off the caller: a physician calling from a health insurance company. This ...

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 ...

NPR's Michel Martin speaks with American Medical Association President Bruce Scott about how physicians and patients are burdened by insurance companies' systems of prior authorization. A lot has been ...

BRIDGEPORT, W.Va. — By the time Eric Tennant was diagnosed in 2023 with a rare cancer of the bile ducts, the disease had spread to his bones. He weighed 97 pounds and wasn’t expected to survive a year ...