Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...

Derived from real-world prior authorization activity across tens of thousands of specialty practices who use SamaCare, the ...

UnitedHealth Group and CVS Health have standardized data and submission rules for more than half of their prior ...

AI agent answered 163 payer questions autonomously in a single submission; platform enables patients to start complex therapies in as few as 48 hours BOSTON, April 21, 2026 /PRNewswire/ -- ...

Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...

Bipartisan lawmakers have introduced the Medicare Advantage Improvement Act of 2026, aiming to curb prior authorization delays and align private plan rules with traditional Medicare. The move comes ...

CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits. The plan mandates electronic processes, faster decision timelines, and ...

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 ...

For many in long-term care, Monday’s announcement about voluntary prior authorization reforms reeks of unpleasant déjà vu. That’s because they’ve been denied before. In 2018, several major insurers ...

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 ...

Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences. Many states have adopted or are ...

Cigna is the latest health insurer to roll back prior authorization requirements, announcing Thursday that it will no longer require the approvals for nearly 25% of medical services. Cigna plans to ...