DrFirst chief medical officer Dr. Colin Banas and EVP, corporate strategy Drew Hunsinger join The MM+M Podcast to discuss ...

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 ...

Most insurers have been compliant with public reporting requirements for prior authorization issued by the CMS, but whether the increased transparency actually helps patients is still an open question ...

I recently had the good fortune to spend many hours on the phone with our family’s health insurance provider. I know what you’re thinking: How can I do that too? It’s easy. All you have to do is try ...

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 ...

The Iowa House and Senate have unanimously approved a bill that sets some state rules for prior authorization, the process insurance companies and government-run insurance programs use before ...

The first specialty medications added, Vivitrol and Epidiolex, are used to treat substance use disorder and epilepsy. “CVS Caremark and Surescripts share a commitment to transform the prior ...

CLEVELAND, Ohio — Prior authorization is the top challenge that Americans have when navigating the health care system, according to a new KFF poll. About 32% of those polled said prior authorization ...

Artificial intelligence has become healthcare’s favorite scapegoat, especially in insurance. Every denied claim, every delayed approval, every inexplicable “not medically necessary” response seems to ...

Semaglutide (GLP-1) drugs like Ozempic are designed to treat type 2 diabetes, but are widely known for their effect on weight loss. Credit: Shahrzad Rasekh / CT Mirror Groups representing low-income ...

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services for several years as part of its broader effort to curb ...