If a person’s Medicare plan requires prior authorization, their doctor will typically take responsibility for submitting the request. A person may need to complete certain forms beforehand.

Prior authorization is the process through which a doctor seeks approval from a person’s health insurance plan before ordering a specific medication or medical service. Original Medicare (parts ...

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 ...

Rep. Mark Green (R-Tenn.) reintroduced a bill Thursday seeking to reform prior authorization requirements in Medicare, Medicare Advantage, and Part D prescription drug plans requiring only ...

If you or someone you know has experienced the frustration of a delayed medical procedure or a denied prescription due to prior authorization, you’re not alone. That’s why Indiana lawmakers ...

The implementation of AI has become widespread in healthcare, but physicians are concerned that unregulated AI use is increasing prior authorization denials, according to a May 7 report by the ...

In addition to concerns about AI, the survey revealed concerns about delays in care, health care costs, and physician burnout. Most physicians surveyed expressed concern that health insurance ...

According to a new survey from the American Medical Association (AMA), 3 in 5 physicians (61%) are concerned that health plans’ use of AI is increasing prior authorization denials ...

ask your health plan how to complete the form and loop in your care provider for the details you’ll need. How Does an Insurer Make Prior Authorization Decisions? Generally, your plan’s ...

Prior authorization requirements are a hallmark of American health care — and for some, they’re long overdue for reform. In North Carolina, a bill to restrict prior authorization — or even ...

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.

Prior authorization has long been a contentious process in health care. Providers often see it as a barrier to patient care, while health plans recognize the process as essential for cost control ...