Ohio is one of six states testing an AI-led prior authorization program for around a dozen medical procedures for patients ...

For many in long-term care, Monday’s announcement about voluntary prior authorization reforms reeks of unpleasant déjà vu. That’s because they’ve been denied before. In 2018, several major insurers ...

AHA supports the Administrations role in facilitating the health insurer pledge to reform prior authorization processes announced on June 23.

Health plans are unnecessarily burdened by administrative tasks such as prior authorization—a costly bottleneck to optimized care and operational outcomes. Recent American Hospital Association (AHA) ...

Following years of complaints about a lack of transparency in Medicare Advantage plans, federal officials announced Tuesday that audits they launched earlier this year have led to significant new ...

Two key lawmakers reintroduced a bill on Wednesday that would essentially codify parts of a Biden administration rule that aims to streamline the use of prior authorization in Medicare Advantage. The ...

"These shortages aren't just about an insufficient supply; they're fueled by burnout," said Dr. Paola Ballester, MD, ...

A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically necessary services. Medicaid managed care organizations (MCOs) denied one out ...

Gift Article 10 Remaining As a subscriber, you have 10 articles to gift each month. Gifting allows recipients to access the article for free. Health Care Service Corp. is expanding a pilot integration ...

Gov. Jared Polis ordered the Colorado Department of Health Care Policy and Financing to reinstate prior authorization for ...