Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

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 ...

Traditional Medicare, also known as original Medicare, has historically required little in the way of pre-authorization for beneficiaries seeking services; pre-authorization was typically the domain ...

The push to revamp prior authorization practices has picked up steam recently. Some physicians and other healthcare leaders have long been outspoken about the issues created by strict prior ...

Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

Here are 10 things for ASCs to know regarding prior authorization in 2024: 1. CMS updated its interoperability and prior authorization final rule at the beginning of the year. The rule requires payers ...

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 ...

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 ...

(L-R) White House AI and Crypto Czar David Sacks, Secretary of Health and Human Services Robert F. Kennedy Jr., President Donald Trump, Centers for Medicare and Medicaid Services Administrator Mehmet ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor prescribes an unusual, experimental, or expensive medication or procedure, the ...

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining in prior authorizations -- remains on both parties' radar screens, ...