Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's ...

Prior authorization was rated a major burden by 32% of insured adults and the single greatest barrier by 34%, surpassing ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

Drugs were left out of a 2024 rule streamlining prior authorizations, including by making decisions electronic and requiring ...

Issued Friday, the proposed rule also would require full disclosure of claims denials and appeals outcomes, according to a ...

A 2024 CMS rule now requires payers, including Medicare Advantage plans, Medicaid, CHIP and ACA exchange carriers, to publicly report prior authorization metrics for the first time. The public ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

In a move that could give patients quick access to drugs their doctors prescribe, the U.S. CMS is proposing a rule giving insurers no more than 24 hours to respond to urgent prior authorization ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

Last summer, the insurance industry broadly agreed to reform a major healthcare pain point: prior authorization. | Last ...

The impact of using AI to evaluate these prior authorizations is unclear. AI could allow tech companies to automatically approve more cases, which could speed up decisions. However, companies could ...