Democrats push for more data on Medicare AI prior authorization pilot

The letter to the CMS from Democrats is the latest salvo from lawmakers concerned that WISeR is delaying care to Medicare ...

Medicare Advantage plans denied prior authorization requests at unusually high rates, HHS report finds

UnitedHealthcare, CVS Health and Humana had the highest denial rates for long-term care requests, according to a report from the agency’s inspector general.

Prior authorization bill now eligible for House fast track

Legislation aimed at reducing delays when Medicare Advantage plans require preapproval for care could hit the House floor under fast-track rules for bills that have broad support. The bill, sponsored ...
Forbes

Prior Authorization Reform Is Here — And It Could Change How Millions Get Care

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 ...

Medicare's AI push snarls patients and doctors in errors and delays

Medicare is testing the use of artificial intelligence to preapprove several healthcare services.

Medicare's prior authorization experiment is off to a rocky start

Traditional Medicare beneficiaries generally don't need prior authorization before receiving medical treatment.In January, however, a new pilot program launched by the Centers for Medicare and ...
Healthcare IT News

Electronic prior auth helps one practice slash 24 hours of manual work per week

Staff at Arkansas' Harmony Park Family Medicine have been excited about streamlining the prior authorization process with the goal of improving patient access to high-quality care. Prior authorization ...
Fierce Healthcare

Industry Voices—Prior authorization regulations: Where they fall short, where we’re moving the needle

Recent legislation aims to streamline processes and reduce denials but does not yet cover all scenarios, such as changes in medical necessity during procedures. Further legislative efforts are needed ...
MedPage Today

What to Expect for Prior Authorization in 2026

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 ...
Fierce Healthcare

A look at the state of prior authorization in Medicaid

A new analysis from KFF and Health Management Associates takes a dive into prior authorization practices for Medicaid managed care organizations. The study polled state programs on policies in place ...
Medscape

New Federal Prior Auth Rule Will Reduce Doctors' Burden, Improve Patient Care, Groups Say

Physicians groups on January 17 hailed a new federal rule requiring health insurers to streamline and disclose more information about their prior authorization processes, saying it will improve ...
Medscape

Have a Prior Auth Problem? Introducing 'Gatekeepers of Care,' Medscape's New Series on Challenges Accessing Cancer Treatment

Health insurance exists to protect people, providing access to routine or potentially lifesaving care without breaking the bank. However, having insurance does not necessarily guarantee access or ...