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

On January 1, impacted payers will have limited time to respond to prior authorization requests, as mandated in the ...

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual National Meeting in Atlanta, Georgia. The Model, sponsored by Mississippi ...

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 ...

announced today that , the leading physician-owned health plan in South Dakota, has implemented RxEOB’s pharmacy prior authorization automation technology for use by its network of physicians who ...

Electronic health record providers are starting work that could transform how nursing homes grapple with prior authorization requests and length of stay determinations.

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

To combat growing criticism of prior authorization delays by payers, Centers for Medicare & Medicaid Services finalized a rule Wednesday that requires health plans to send prior authorization ...

Cigna is the latest health insurer to roll back prior authorization requirements, announcing Thursday that it will no longer require the approvals for nearly 25% of medical services. Cigna plans to ...