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

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

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 ...

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

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.

PSG’s research found that payers are placing more attention on specialty drugs covered under the medical benefit, showing ...

Prior authorization (PA)—where healthcare access, costs, and patient experience meet—has long been considered by many as a necessary evil in the effort to rein in U.S. pharmacy costs while improving ...

Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...

The first specialty medications added, Vivitrol and Epidiolex, are used to treat substance use disorder and epilepsy. “CVS Caremark and Surescripts share a commitment to transform the prior ...

Optum Rx, the pharmacy benefit manager under UnitedHealth Group, is set to eliminate prior authorization requirements for approximately 80 prescription drugs in an effort to simplify access to ...

Today, careviso, a leader in automation-enabled patient access, announced the release of its real-time pharmacy benefit ...