A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial ...

In October, CMS announced the launch of a new prior authorization demonstration that would introduce new requirements for select services. This comes just four months after news of an agreement ...

The program was first announced in June by Health and Human Services Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, ...

The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual National Meeting in Atlanta, Georgia. The Model, sponsored by Mississippi ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

The requirements will make exchanging health data more efficient and reduce administrative burden. Today CMS finalized the Interoperability and Prior Authorization Final Rule, continuing its efforts ...

In a recent survey, 84% of providers reported the number of medical services that require prior authorization has increased. And 62% of providers reported that they do not have the technology to ...

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...