Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare ...

Technology hurdles, particularly lack of standardization and interoperability, often hinder the prior authorization process. Robust communication strategies can address those problems.

Rep. Dr. Greg Murphy (R-N.C.) hopes his personal ordeal with prior authorizations will help inspire Congress to act.

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

Insurance hurdles and the complexities of prior authorization create barriers to care, according to oncologists in a new ...

But what happens when prescribed care is denied? The stated objectives of prior authorization (PA) are to reduce unnecessary care and costs. However, as a 2022 Department of Health and Human Services ...

As the state legislative session comes to a close, Springfield state Rep. Melanie Stinnett is holding out hope that the Missouri General Assembly will come to an agreement on legislation limiting ...

The California Assembly is considering a bill that would shorten the standard time limit for prior authorization reviews to 48 hours, from 5 business days today. The bill would cut the time a plan ...

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 ...