Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...

Medicare Advantage plans use prior authorization to manage health care use. In recent years, these practices have come under intense scrutiny from policy makers. Using beneficiary enrollment data and ...

WASHINGTON -- A top health official at the Centers for Medicare & Medicaid Services (CMS) hedged on payment reform, but committed to helping physicians address prior authorization challenges, during ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and ...

Whether you’re filling a prescription or scheduling a procedure, chances are you’ve been asked whether you have prior authorization. By learning to navigate prior authorization and what steps to take ...

Medicare Advantage plans would have to respond to urgent prior authorization requests for medications within 24 hours, and standard requests within 72 hours, under a proposed rule from the Centers for ...

Blaming prior authorization for “eroding trust between payers and providers,” federal officials said Monday they are evaluating how prior approvals might be better targeted to improve healthcare ...

The letter to the CMS from Democrats is the latest salvo from lawmakers concerned that WISeR is delaying care to Medicare ...

Digital and privacy rights nonprofit Electronic Frontier Foundation is suing the Centers for Medicare & Medicaid Services (CMS) to get more information about a multi-state program that is using ...