Beginning next year, the CMS will launch an AI-powered prior authorization process for some services as it seeks to cut ...

Prior authorization refers to when medical providers have to get approval from insurers before performing a service. Patients ...

CMS has unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative that will add prior authorization for some traditional fee-for-service Medicare services.

Delays in prior authorization can in turn delay treatment — and therefore relief — for suffering patients. (While the majority of prior authorization requests are approved, the share of denials is ...

The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization ...

As payers announce plans to improve prior authorizations, two spine surgeons discuss the changes that would make the most difference for them. Ask Spine Surgeons is a weekly series of questions posed ...

Medicare Advantage plans prior authorization denial rates and success rate of overturning denial on appeal In 2023, insurers fully or partially denied 6.4%, or 3.2 million, prior authorization ...

According to a National Conference of State Legislatures database, 23 states enacted more than 43 bills related to prior authorization in the last few years, with 18 enacted so far in 2024 alone.

For patients and doctors, insurance prior authorization can be a dangerous game | Opinion But it is not a game. For one of our leukemia patients, he lost time fighting to get pain medication ...

Prior authorization serves an important purpose. It is one of the few tools to keep health care costs in check, ensuring that treatments are medically necessary and cost-effective.

Prior authorization is frustrating for doctors, drives our burnout, and wastes our time, but more importantly, it harms patients. It needs to be rightsized; it needs to be fixed ...