Blue Shield is designing a centralized, machine-readable policy repository to enhance policy digitization and automation, speeding up prior authorization decisions. The organization has partnered with ...
A KFF survey published today found that people view prior authorization as the biggest challenge beyond costs when navigating ...
A six-state pilot program will target 'wasteful care' under Medicare Medicare programs in six states will face prior authorizations under a new pilot program. Traditional Medicare in six states will ...
Traditional Medicare in six states will soon feel more like privatized Medicare Advantage, using prior authorizations to determine what care can be covered for older adults. Starting in January, about ...
A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...
At least 18 states took action on health insurers’ use of prior authorization this year, a sign that lawmakers aren’t content to wait on federal regulators to step in on a key consumer and provider ...
Prior authorization (PA) is a utilization management technique used by health insurers that requires providers to seek approval from the insurance plan before the plan will agree to pay for a covered ...
A new bill from Democratic lawmakers seeks to repeal a controversial bill from the Centers for Medicare and Medicaid Services that would put artificial intelligence at the forefront of medical ...
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The lawmakers argue the CMS innovation center model, which will implement AI-backed prior authorization for some services in six states, will add red tape and limit access to care. The bill, called ...
Prior authorization is a barrier to accessing medications for opioid use disorder (MOUD). Although private insurance covered about one-third of patients with OUD in 2023, the understanding of prior ...
A breast cancer diagnosis should trigger immediate action. But for many patients, the journey to treatment begins with delays, often caused by outdated prior authorization (PA) processes. Designed to ...
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