Massachusetts insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements ...

Company’s chief product officer explains how his company is helping eliminate the technical complexity and manual burden of ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Aetna has announced it is integrating pharmacy prescriptions and medical procedures into a single clinical review to streamline the prior authorization process. The prior authorization bundles are for ...

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 ...

The Centers for Medicare and Medicaid Services has selected the six technology companies that will administer artificial intelligence-powered prior authorization programs for Medicare, STAT has ...

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A new bill from Democratic lawmakers seeks to repeal a controversial bill from the Centers for Medicare and Medicaid Services that would put artificial intelligence at the forefront of medical ...

We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...

The Wasteful and Inappropriate Service Reduction initiative from CMS is set to take effect Jan. 1, 2026, introducing new prior authorization requirements for select services. Here are seven things to ...

The American Hospital Association is urging CMS to delay its Medicare prior authorization pilot — the Wasteful and Inappropriate Service Reduction initiative — by at least six months. “This timeframe ...

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 ...