A new CMS demonstration project aimed at curbing Medicare fraud is set to begin on Sept. 1, 2012. The initiative is limited to physicians and suppliers of durable medical equipment in seven states ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

Prior authorization has emerged as a flash point between payers and providers as the former tries to manage what they believe is waste in the system while the latter accuses payers of trying to deny ...

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

A major pain point for physicians is also one—sometimes literally—for patients. In Texas, 25% of patients say insurers have refused to cover a medicine, procedure, test or scan that a doctor ordered ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...