Six states are part of a pilot program by CMS to reduce “waste, fraud and abuse.” ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...

Major health insurers are advancing efforts to standardize prior authorization requirements as part of an effort to simplify ...

Leading health plans will adopt a standardized approach for providers submitting electronic prior authorization requests for the majority of medical services, which they say will accelerate ...

Major U.S. health insurers report an 11% overall reduction in prior authorization requirements, with Medicare Advantage cuts exceeding 15%. The changes follow a 2025 multi-payer pledge to streamline ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's what you need to know.

Participating payers reported an 11% reduction in prior authorization requirements overall, with Medicare Advantage exceeding ...

Aligning electronic data submission requirements for prior authorizations is one prong of the insurance industry’s commitment ...

UnitedHealth Group and CVS Health have standardized data and submission rules for more than half of their prior ...

Chapter reports on avoiding common Medicare Advantage issues like high costs, prior authorization delays, and provider access ...

Whether you’re filling a prescription or scheduling a procedure, chances are you’ve been asked whether you have prior authorization. By learning to navigate prior authorization and what steps to take ...