Medicare recipients now face new hurdles in getting their care covered -- but only in a few states.
Surveyed medical groups reveal burdens have increased in the past 12 months, resulting in delays or denials for necessary care. Despite scrutiny of prior authorization practices in Medicare Advantage ...
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 ...
Prior authorization — in which a patient needs approval from the health plan before proceeding with a medical service — has long created a rift between payers and providers. It has gotten such a bad ...
New effort will expedite approvals, promote access to care, reduce administrative burdens, and enhance the patient experience LOUISVILLE, Ky.--(BUSINESS WIRE)-- Humana Inc. (HUM), a leading health and ...
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 ...
CMS is launching a six-year pilot of the WISeR Model, starting January 2026 in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington, which will use AI and human review to expand prior ...
Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...
As payer prior authorization requirements grow more complex, ASCs are increasingly caught in what one administrator describes as a “game of chicken” between patient care and financial survival. Elisa ...
States, physicians and healthcare organizations have all pushed to lessen the burden of prior authorizations on the practice of medicine in 2023. Eliminating rigid prior authorization requirements has ...
Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...
(Reuters) -Humana said on Tuesday it would eliminate about one-third of prior authorizations for outpatient services by next year, the latest insurer to address the tedious paperwork process that has ...
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