A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

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

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 ...

Recognition validates operator-led approach to solving administrative burden that costs U.S. healthcare system $31B ...

Health insurance companies are expected to hold to their promises in 2026 to “streamline, simplify and reduce” prior ...

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

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

The program was first announced in June by Health and Human Services Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, ...

In August, AHIP, the trade association for health insurance companies representing the industry’s top players, announced that they reached a deal with the White House to reform prior authorization for ...

Aetna has announced it is integrating pharmacy prescriptions and medical procedures into a single clinical review to streamline the prior authorization process. The prior authorization bundles are for ...

The last stage of prescribing may involve coordination between multiple parties, but it no longer needs to be defined by ...

New Brunswick, N.J.-based St. Peter’s Healthcare System CFO Garrick Stoldt said his health system is feeling ready for the new traditional Medicare prior authorization pilot that is set to begin Jan.