CMS has unveiled the Wasteful and Inappropriate Service Reduction model, a new Innovation Center initiative aimed at reducing unnecessary services in traditional Medicare and streamlining the prior ...

A new study found that almost all plans in 40 states and Washington, DC covered at least one form of the opioid overdose ...

Health insurance companies are set to streamline, simplify and reduce the pre-approval process by transitioning to an ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care ...

Major insurers say they’ll ease up on the prior-authorization practice that can delay necessary care for patients.

Major insurers have agreed to six commitments that should make accessing care easier for patients while removing ...

The Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F), which goes into effect on January 1, 2027, will require impacted payers to ...

Some progress is being made in the industry: the Centers for Medicare & Medicaid Services passed a final rule on streamlining prior authorization processes in 2024, but private industry leaders ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...