Behemoth health insurers claim this time-wasting practice improves care and saves everyone money. Look beyond the myths and find out the facts.

The Iowa legislature has unanimously voted to set deadlines for insurance companies being asked to authorize treatment, ...

CMS Rule 0057 requires health plans to develop and support FHIR-based APIs to enable electronic prior authorization (ePA). Whether return on this investment stops at ...

While the final rule solidifies several changes — including measures to streamline prior authorization, tighten oversight of supplemental benefits and codify provisions from the Inflation ...

This story also ran on CBS News. It can be republished for free. Do you have experience with prior authorization you’d like to share with us for KFF Health News’ reporting? Tell us here. Sometimes, as ...

CMS finalized a key provision that holds Medicare Advantage insurers responsible for paying inpatient hospital admissions claims previously approved through the prior authorization process.

A bill to reform prior authorization requirements for Medicare Advantage (MA) – a massive burden that nursing home operators have been trying to change for some time – was reintroduced on Capitol Hill ...

Rep. Mark Green (R-Tenn.) reintroduced a bill Thursday seeking to reform prior authorization requirements in Medicare, Medicare Advantage, and Part D prescription drug plans requiring only ...

Rep. Mark Green (R-Tenn.) reintroduced a bill Thursday seeking to reform prior authorization requirements in Medicare, Medicare Advantage, and Part D prescription drug plans requiring only specialty ...

In addition to concerns about AI, the survey revealed concerns about delays in care, health care costs, and physician burnout. Most physicians surveyed expressed concern that health insurance ...

4x faster trend analysis to identify utilization pattern changes and outliers "Health plans want to support providers in delivering appropriate patient care and reducing abrasion," notes Cohere ...

If you or someone you know has experienced the frustration of a delayed medical procedure or a denied prescription due to prior authorization, you’re not alone. That’s why Indiana lawmakers ...