As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

The start of the legislative session is just around the corner. Beginning in December, the Missouri Senate allows senators to ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...

Payers have new deadlines to issue prior authorization decisions — 72 hours for urgent requests and seven days for non-urgent ones. Prior authorization is a process wherein a doctor must get approval ...

A Medicare pilot program will allow private companies to use artificial intelligence to review older Americans' requests for certain medical care—and will reward the companies when they deny it.

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 ...

Electronic health record providers are starting work that could transform how nursing homes grapple with prior authorization requests and length of stay determinations.

Please provide your email address to receive an email when new articles are posted on . Most medications in allergy and asthma care require prior authorization. Providers should screen for failed ...

They often deny coverage via snail mail. Here’s what happened when my family got a note like that 36 hours before cancer surgery. By Ron Lieber Disease doesn’t ask permission before invading a body, ...