Submit an appeal, even if you're worried you’ll lose. Yaver said that, based on the research set to be published in her book, Coverage Denied: How Health Insurers Drive Inequality in the United States ...

Under state law, at least one version of liquid methadone, a drug used for the treatment of opioid use disorder, must be ...

Starting May 1, enrollees in UnitedHealthcare health maintenance organization (HMO) or HMO-point of service Medicare ...

Less than 36 hours before his wife was scheduled to undergo major surgery, New York Times personal finance columnist Ron Lieber got an unwelcome letter from his family's insurance plan: It was denying ...

Aetna joins Humana and United Healthcare in providing Medicare Advantage coverage for beneficiaries who meet medical necessity criteria for the ...

CVS Health (CVS) on Thursday announced that it plans to make a large portion of its prior authorization procedures consistent with cross-payer clinical and technology standards. Therefore, the company ...

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

Millions of seniors with Medicare Advantage plans can expect slimmed-down benefits, loftier premiums, and a reduced selection of options in 2026 plans. What that means: This is not the year to skip ...

Three new studies highlighted the growing burden of prior authorization on both oncologists and patients. Findings from a survey of radiation oncologists, for instance, revealed that more than 80% ...

Medicare enrollees in Washington and five other states could soon need preapproval for certain medical services — a familiar hurdle for commercial insurance plans, including Medicare Advantage, but ...