Prior authorization — the process by which insurers review and approve or deny treatments prescribed by doctors — has become “the only piece of healthcare that every single stakeholder, including ...

Recipients of Medicaid frequently face prior authorization hurdles when pursuing medical care or treatment. Medicaid is a joint federal–state public health insurance program that provides healthcare ...

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 ...

With debates ongoing around prior authorization in the U.S. healthcare industry, a December 2021 survey by the American Medical Association found that 51% of physicians said the practice interfered ...

Prior authorization is a process wherein a doctor must get approval from a patient’s health insurer before providing a medical service, like prescribing a drug or performing a surgery. Payers argue ...

Major health insurers have pledged to improve the prior authorization process, which has long frustrated Americans.

To combat growing criticism of prior authorization delays by payers, Centers for Medicare & Medicaid Services finalized a rule Wednesday that requires health plans to send prior authorization ...

The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement ...

Why do I need a prior authorization for something that I am already prior-authorized to take? If my doctor says that they want me on a medication, why does my insurance have another say in that?” — ...