HealthDyne’s Sarah Thomas and David Skomo say that direct-to-patient arrangements eliminate opacity in drug pricing and allow ...

A New York-based speciality pharmacy has agreed to pay $115,000 to settle allegations it committed prior authorization fraud. The U.S. Justice Department accused DJ Drugs & Surgicals of submitting ...

CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits, introducing electronic workflows, faster decision timelines, and greater ...

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

Just as it is important for retail analysts to understand the choices their customers make and why they may choose not to purchase a specific item, so is it important for the specialty pharmacy ...

As of today, Optum Rx is nixing reauthorization requirements for more than 60 additional medications. The pharmacy benefit management giant revealed a list of drugs that includes products for ...

Optum prior auth tool reduces prescription approvals from 8 hours to 30 seconds, lowering denials and appeals for UnitedHealth Group clients.

FLORHAM PARK, N.J. — Specialty pharmacy company Amber Pharmacy has implemented a prior authorization system provided by Armada Health Care, Amber said. Amber announced that it had incorporated ...

Fierce Healthcare hosted its second annual in-person Payer Summit conference in Austin, Texas, on Nov. 13-14. Payer industry executives gathered with Fierce Healthcare journalists to discuss the most ...

CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits, mandating electronic workflows, faster decision timelines, and greater ...

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.