A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

Health insurance companies are expected to hold to their promises in 2026 to “streamline, simplify and reduce” prior ...

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

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 ...

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 ...

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 ...

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, ...

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 ...

NPR's Michel Martin speaks with American Medical Association President Bruce Scott about how physicians and patients are burdened by insurance companies' systems of prior authorization. A lot has been ...

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 ...

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 ...