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

Weeks pass without a word from your insurance company. You call, you wait, you call again. Eventually, you find out your ...

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 ...

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

The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

UnitedHealthcare, facing a storm of backlash from docs over its decision to implement a policy that would require prior authorization for some surveillance and diagnostic colonoscopies, is pushing ...

Artificial intelligence will soon be used for prior authorization for certain Medicare services in Texas and five other ...

Medicare in January will begin AI-powered pre-treatment reviews for select health services in a major policy change that's aimed at rooting out unnecessary care — but alarming providers. Why it ...

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 ...

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But in practice, it often means delayed appointments, stalled medication ...

In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations. UnitedHealthcare (UHC) is the latest to cut back on its prior authorization ...