Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

Health plan executives expect AI to automate prior authorizations, improving turnaround times amid CMS regulatory changes, ...

Massachusetts insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements ...

Powered by Phare Access – the smart patient access hub of R1’s Phare Operating System – R1 Prior Authorization manages the ...

Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service ...

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 ...

A screen displays the logo and trading information for Humana on the floor of the NYSE in New York (Reuters) -Humana said on Tuesday it would eliminate about one-third of prior authorizations for ...

Health plan members of AHIP and the Blue Cross and Blue Shield Association made news earlier this week when they announced a series of steps that a broad swath of health insurers will take to improve ...

The Centers for Medicare and Medicaid Services (CMS) recently announced the launch of a program that will require individuals on Medicare to obtain prior approval from the federal health insurance ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. On June 27, 2025, the Centers for Medicare and Medicaid ...

Aetna provided an update on its efforts to streamline the healthcare experience on Thursday, one year to the day after the fatal shooting of UnitedHealth’s top insurance executive sparked a wave of ...