The travel industry has completely changed, and it is being driven by one massive demographic: solo female travelers. As of ...

The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

A 2024 CMS rule now requires payers, including Medicare Advantage plans, Medicaid, CHIP and ACA exchange carriers, to publicly report prior authorization metrics for the first time. The public ...

The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for ...

Last summer, the insurance industry broadly agreed to reform a major healthcare pain point: prior authorization. | Last ...

Insurers have cut prior auth requirements by 11%, reducing 6.5 million authorizations and easing access across Medicare Advantage and commercial plans.

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

It’s a lucrative shakedown if you can get it, and insurers have been getting it since the passage of the 1973 Health ...

Doctors in multiple states report unpaid claims and care delays under the new federal program, as a lawsuit seeks answers about AI algorithms and data security.

Out-of-pocket premiums for Affordable Care Act plans increased 58% this year, after Congress allowed more generous subsidies for coverage to expire, according to new data from the CMS. Consumers on ...