Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. On June 27, 2025, the Centers for Medicare and Medicaid ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

A screen displays the logo and trading information for Humana on the floor of the NYSE in New York (Reuters) -Humana said on Tuesday it would eliminate about one-third of prior authorizations for ...

R1 RCM has launched a new tool designed to automate and streamline the prior authorization process at scale. The tool, called ...

Health plan executives expect AI to automate prior authorizations, improving turnaround times amid CMS regulatory changes, Deloitte finds.

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

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 ...

Aetna provided an update on its efforts to streamline the healthcare experience on Thursday, one year to the day after the fatal shooting of UnitedHealth’s top insurance executive sparked a wave of ...