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

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

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

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare Advantage prior authorization requests for medications to 24 hours and ...

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

The Centers for Medicare & Medicaid Services’ 2026 final rules update payment policies and prior authorization timelines to speed care decisions and increase transparency. Standard prior authorization ...

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.

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 ...

A CMS pilot program that would add prior authorization for some traditional fee-for-service Medicare services has come under increased scrutiny by some members of Congress, including a call to pause ...