The proposed rule aims to improve prior authorization for prescription drugs by establishing and requiring electronic prior ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

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, ...

Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: ...

Aetna provided an update on its efforts to streamline the healthcare experience on Thursday, one year to the day after the fatal shooting of UnitedHealth’s top insurance executive sparked a wave of ...