Medicare Original's historic freedom is set to change. Starting January 1, 2026, prior authorization will be required for ...

The six-year WISeR Model trial begins January 2026, affecting traditional Medicare recipients seeking certain medical procedures.

Insurance companies often make doctors ask their permission before treating patients. This template can help medical ...

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining ...

Medicare is launching a new program that could increase denials of certain treatments. Here’s how to push back against a denial.

Dr. Paola Ballester, a visionary physician-innovator and CEO of an AI-powered healthcare platform, joins the ...

Health insurance companies will have to invest in technology and update their administrative processes to comply with new prior authorization requirements. The Centers for Medicare and Medicaid ...

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, ...

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

To control costs, nearly all health insurers use a system called prior authorization, which requires patients or their providers to seek approval before they can get certain procedures, tests, and ...

The additional red tape could save money, but may harm patient access and quality of care. Stakeholders are urging the CMS to ...

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...