Most non-emergency care at non-VA facilities requires the VA's approval before you schedule. This includes routine appointments, specialist consultations, procedures and diagnostic tests that aren't ...

A CMS pilot program will require providers in six states to submit select Medicare services for AI-enabled prior authorization or post-service medical review.

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

The start of the legislative session is just around the corner. Beginning in December, the Missouri Senate allows senators to ...

On January 1, impacted payers will have limited time to respond to prior authorization requests, as mandated in the ...

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 ...

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 ...

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 ...

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 ...

A breast cancer diagnosis should trigger immediate action. But for many patients, the journey to treatment begins with delays, often caused by outdated prior authorization (PA) processes. Designed to ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

Providers are betting on artificial intelligence to ease the pain point of prior authorization, a new survey shows. Cohere Health, which provides clinical intelligence to insurers and risk-bearing ...