Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

A new CMS demonstration project aimed at curbing Medicare fraud is set to begin on Sept. 1, 2012. The initiative is limited to physicians and suppliers of durable medical equipment in seven states ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor ...

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

In a recent survey, 84% of providers reported the number of medical services that require prior authorization has increased. And 62% of providers reported that they do not have the technology to ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

A major pain point for physicians is also one—sometimes literally—for patients. In Texas, 25% of patients say insurers have refused to cover a medicine, procedure, test or scan that a doctor ordered ...

In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior ...