Administrative costs are estimated to make up between 20 and 34 percent of US health care expenditures, roughly 1–4 percent of GDP. Academic and policy discussions generally characterize these costs ...

The Centers for Medicare and Medicaid Services has issued a proposed rule updating the prior authorization process for Medicare Part D coverage of prescription drugs picked up at the pharmacy counter.

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 ...

Cleveland-based MetroHealth has improved the speed and success of its medication prior authorization process with the help of AI, cutting submission times from 18 hours to around five minutes and ...

Optum Rx has announced it will drop prior authorization for an estimated 80 drugs starting May 1. The program targets reauthorizations of drugs. For instance, once a genetic condition such as cystic ...

Natalie Tate, PharmD, is vice president of pharmacy at BlueCross BlueShield of Tennessee. Nationwide, prescription drugs are the costliest and commonly used heath plan benefit. Last year, BlueCross ...

Credit: Getty Images. Prior authorization requirements for oral cancer drugs on Medicare part D formularies have increased in recent years, research suggests. Prior authorization requirements for oral ...

Optum Rx — which includes the pharmacy benefit manager of health care conglomerate UnitedHealth Group — is dropping annual reauthorization requirements for 80 drugs, which will eliminate more than 10% ...

Prior authorization requirements for PCSK9 inhibitor prescriptions are more cumbersome than those in place for other cardiometabolic drugs, a new study demonstrates. The complex processes are seen for ...