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 ...

Berwick is a former administrator of the Centers for Medicare and Medicaid Services. He is a senior fellow for health policy and Ducas is the VP of health policy at the Center for American Progress.

Editor’s note: David Charles is a practicing neurologist and chief medical officer at the Alliance for Patient Access. The first draft of this piece was written by Amanda Conschafter, communications ...

Medicare Advantage plans could look dramatically different if a new law passes in the Senate. For years, seniors have complained about prior authorization ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups. UnitedHealth, which operates the biggest ...

Fortunately, prior authorization requests tend to spike in specific areas. Plans working with InterSystems uniformly report that a limited number of procedures account for an outsized share of ...

Prior authorization will become less of a hassle for physicians in Blue Cross Blue Shield of Michigan’s network, BCBSM officials hope, as they roll out an effort to relax about 20% of prior ...

As US health insurers promote a new joint plan to overhaul prior authorization (PA) as a major advance, clinician and patient advocates say insurers have provided few specifics about what will change ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

Insurance companies often make doctors ask their permission before treating patients. This template can help medical professionals explain how it works. By Ron Lieber Ron Lieber will update this ...

Eye specialists say they are seeking to prevent disruption of patient care from a new Humana Inc policy that delegates review of prior authorization for cataract surgery for its Medicare Advantage ...