Medicare Advantage plans use prior authorization to manage health care use. In recent years, these practices have come under intense scrutiny from policy makers. Using beneficiary enrollment data and ...

Over years of working on prior authorization, both at the state level and alongside colleagues across the country, I've seen ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

(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 ...

Zack Sigel is a writer and editor based in New York City. He has been managing editor at Policygenius and M1 Finance, where he led teams specialized in writing about business and finance, and he has ...

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 ...

Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: ...

A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and ...

UnitedHealthcare is eliminating authorization requirements for 30% of healthcare services that previously required insurer approval, the nation's largest insurer said. Prior authorization is currently ...