“Historic” cuts to Medicaid are looming, placing optional services such as home- and community-based services on top of the list of cuts if states lose federal Medicaid dollars, according to the ...

Legislation focused on prior authorization reforms is headed to the governor after Senate lawmakers approved changes to the bill Wednesday. Lawmakers said the bill is an important step in ...

(Brandon Smith/IPB News) Legislation focused on prior authorization reforms is headed to the governor after Senate lawmakers approved changes to the bill Wednesday. Lawmakers said the bill is an ...

Most physicians surveyed expressed concern that health insurance companies’ use of artificial intelligence (AI) is increasing prior authorization denials. 1 The survey, conducted by the American ...

Rep. Mark Green, MD, of Tennessee has reintroduced legislation taking aim at prior authorization requirements in Medicare, Medicare Advantage and Part D prescription drug plans. Five things to ...

Temporarily dropping prior authorization requirements made sense for Ohio ... Gainwell’s contractual responsibilities include recovering overspent funds. Many Medicaid patients have some form of ...

That help comes in the form of Medicaid. We are hearing conflicting messaging from Washington on whether or not Medicaid cuts will be a part of the federal budget patchwork that ultimately passes ...

In the Medicare Advantage and Part D final rule for 2026 issued Friday, the Centers for Medicare and Medicaid Services ... of artificial intelligence in prior authorization. The agency also ...

For patient advocates and health economists, cases like Ekirch’s illustrate why prior authorization has become such a chronic pain point for patients and doctors. For 50 years, insurers have ...

Senior living industry advocates say they are looking forward to sharing their priorities and explaining the industry to Mehmet Oz, MD, whose appointment as administrator of the Centers for Medicare & ...

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