Add Yahoo as a preferred source to see more of our stories on Google. In June of this year, CMS announced that it would be launching the Wasteful and Inappropriate Service Reduction (WISeR) Model, ...

Add Yahoo as a preferred source to see more of our stories on Google. Two pharmacy employees work behind the counter in a pharmacy, one on the phone and looking at a computer and the other writes on a ...

A new study has found that prior authorizations for anti–vascular endothelial growth factor treatment led to a delay in patient care for most patients. Anti-VEGF treatments have been used in patients ...

Technology hurdles, particularly lack of standardization and interoperability, often hinder the prior authorization process. Robust communication strategies can address those problems. Prior ...

Major health insurers in the U.S. pledged Monday to overhaul the prior authorization process. Prior authorization means insurers require approval before they’ll cover medical care, a prescription or a ...

Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut funding for what it deems medically unnecessary care. The Center for Medicare ...

The Centers for Medicare and Medicaid Services finalized the CMS Interoperability and Prior Authorization Rule on Wednesday. CMS said the rule will improve the prior authorization process and save ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications. UnitedHealthcare, CVS Health's Aetna and dozens of ...

Six months after Eric Tennant died following a protracted battle with his health insurer over doctor-recommended cancer care, ...

The New Mexico Office of Superintendent of Insurance urges all health insurance consumers to actively monitor the status of any prior authorization requests submitted on their behalf. Prior ...

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 ...