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 ...

New Medicaid prior-authorization rules have advocates in Connecticut concerned about patients losing access to their prescription drugs.

Prior authorization (PA) is a widely used insurance mechanism intended to ensure cost-effective, evidence-based care. However, in practice, it often imposes significant administrative and clinical ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

California is one of 31 states that passed laws in 2025 limiting insurance companies’ use of prior authorization to approve ...

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 ...

Prior authorization is no longer just an administrative hurdle for ASCs; it is a defining constraint on growth. As authorization requirements expand, policies shift and payer scrutiny intensifies, ...

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 ...

61% — The percentage of physicians who said that patients frequently abandon a recommended treatment due to prior authorizations in Medscape’s “They’re Awful and Impede Patient Care: Medscape ...

Dana Kelso Spradling says she's dealing with an insurance nightmare, after the medication she had already received a prior authorization for is now being denied.