Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed ...

Prior authorization can help encourage the efficient use of health care resources but too often, it delays treatment patients ...

AHA pushes CMS delay on Medicare prior authorization pilot set for Jan. 1, 2026, urging changes to reduce provider burden and improve oversight.

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

Navigating the healthcare system can be a complex and frustrating experience for many patients. Among the many challenges, one of the most insidious barriers to timely care is prior authorization.

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

CLEVELAND, Ohio — A new Medicare pilot program set to launch next year in Ohio and other states could change the way older Americans access certain medical treatments, drawing sharp criticism from ...

GoodRx reports that starting January 2026, original Medicare will require prior authorization for certain services in six ...

Prior authorization denials in Medicare Advantage (MA) jumped between 2021 and 2022, according to a new analysis from KFF. Researchers dived into data from the Centers for Medicare & Medicaid Services ...

The new Medicare initiative would apply to claims for procedures such as steroid injections for pain management, electrical nerve stimulator implants, skin and tissue substitutes, devices for ...