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

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 ...

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

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 ...

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 ...

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 ...

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 ...

UnitedHealthcare, the largest private payer in the U.S., plans to eliminate almost 20% of its current prior authorizations starting this summer, the company announced Wednesday. The decision, which ...

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 ...