The system is broken — and it must be fixed now.

The proposed rule aims to improve prior authorization for prescription drugs by establishing and requiring electronic prior ...

Reforming prior authorization processes has been on the regulatory menu for a while. Both patients and providers have argued that prior ...

Meaningful progress requires alignment across providers, payers, EHR developers and others, not isolated adoption, CMS says.

The influential advisory group is recommending policies to boost human oversight and visibility into how Medicaid plans are ...

A majority of physicians say the prior authorization process continues to negatively impact patient outcomes and employee ...

The planned cuts come as payers face ongoing pressure to reduce prior authorization use. For example, a recent initiative led ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

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 ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

Only one-third say that insurer efforts will make a real difference ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...