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 ...

Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Cigna is the latest health insurer to roll back prior authorization requirements, announcing Thursday that it will no longer require the approvals for nearly 25% of medical services. Cigna plans to ...

Next year, Texas will be one of six states participating in a Medicare pilot program that uses artificial intelligence to review certain patient service requests to reduce fraud, waste and abuse.

Ask a provider what’s causing tension in their relationship with insurers and many will point to prior authorization, arguing that the practice creates administrative burdens and delays in patient ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

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

UnitedHealthcare, the largest private payer in the U.S., plans to eliminate almost 20% of its current prior authorizations starting this summer, the company announced Wednesday. The decision, which ...

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 ...