Major health insurers say they have cut prior authorizations, but the AMA says physicians report that the burden of prior ...

The new CMS regulations on prior authorization have been heralded as a big step forward in reducing administrative burdens on physicians, but some people think it doesn't go far enough. The CMS ...

Prior authorization was rated a major burden by 32% of insured adults and the single greatest barrier by 34%, surpassing ...

When Paula Chestnut needed hip replacement surgery last year, a pre-operative X-ray found irregularities in her chest. As a smoker for 40 years, Chestnut was at high risk for lung cancer. A specialist ...

Use of prior authorization in the Medicare Advantage (MA) program continues to increase, according to a report from KFF. More than 46 million prior authorization requests were submitted to Medicare ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

Each prior auth transaction costs practices between $20 and $30 ...

For the first time, more Medicare enrollees received their Medicare benefits through a Medicare Advantage (MA) plan last year than through Traditional Medicare. We saw first-hand at the Center for ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

The need to fix healthcare’s antiquated prior authorization (PA) process remains a hot-button issue in the industry, garnering policy attention and spurring the development of myriad technology ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...

New Year’s Day, the day of new beginnings, is a day health care providers like me dread. It starts the annual deluge of requests to renew “prior authorizations” — a bureaucratic tactic that insurers ...