CMS is adding prior authorization requirements for certain fee-for-service procedures under traditional Medicare as part of its new Wasteful and Inappropriate Service Reduction model. A total of 17 ...

Major insurers say they’ll ease up on the prior-authorization practice that can delay necessary care for patients.

The model will leverage AI and machine learning for prior authorization of services vulnerable to fraud or inappropriate use, ...

The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance ...

Highmark is among the more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the ...

Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut funding for what it deems medically unnecessary care.

Insurers said Monday that they will standardize electronic prior authorization by the end of next year to help speed up the ...

The Centers for Medicare & Medicaid Services announced a new Innovation Center model aimed at helping ensure people with Original Medicare receive care.

Nearly all customers of Medicare Advantage plans, the privately run version of the federal government's Medicare program, need prior authorization for some services, particularly expensive care ...

UnitedHealthcare, CVS Health's Aetna and dozens of other insurers say they plan to reduce the scope of health care claims subject to prior authorization, standardize parts of the process and ...