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 ...

11/14/2025 Motion to extend the time to file a response from December 1, 2025 to January 15, 2026, submitted to The Clerk. 11/14/2025 Response of Express Scripts, Inc., et al. to motion submitted.

House Democrats on Friday introduced legislation to get rid of the WISEeR model for prior authorization in traditional Medicare. Representatives Rick Larsen (WA-02), Suzan DelBene (WA-01), Kim Schrier ...

We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...

Cigna's Evernorth division is rolling out a rebate-free model for its pharmacy benefit manager, Express Scripts—meaning one of the industry's "Big Three" is moving away from the oft-criticized ...

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 ...

Surescripts®, the nation's leading health intelligence network, today announced a major expansion of its Touchless Prior Authorization technology, now reaching more than 76,000 prescribers across the ...

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 But for many patients, the journey to treatment begins with delays, often caused by outdated prior authorization (PA) processes.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 ...

Getting your Trinity Audio player ready... Therapists treating Medicaid enrollees in Colorado will have to get the state’s authorization to conduct more than 24 sessions with an individual patient in ...

The proportion of Medicare Part D beneficiaries subject to prior authorization for GLP-1 drugs jumped from just a fraction through 2023 to nearly all by 2025. Out-of-pocket costs likewise were steady ...

The program, called WISeR, aims to reduce wasteful spending and fraud in the Medicare system. Doctors and Democrats have raised concerns that the pre-approval process could delay or deny necessary ...

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 ...