Please provide your email address to receive an email when new articles are posted on . UnitedHealthcare recently announced that beginning June 1, 2023, commercial plan members will be required to ...

The approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries ...

In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior ...

Insurers are working to standardize how they vet requests for medical treatments and services, the latest in a series of commitments from the industry to pare back paperwork and make it easier for ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

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 ...

In a recent survey, 84% of providers reported the number of medical services that require prior authorization has increased. And 62% of providers reported that they do not have the technology to ...