The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

For many physician practices -- especially those working with health maintenance organizations (HMOs) -- obtaining pre-authorization to perform certain treatments or procedures is a necessary evil: ...

Medicare recipients now face new hurdles in getting their care covered -- but only in a few states.

Major health insurers in the U.S. pledged Monday to overhaul the prior authorization process. Prior authorization means insurers require approval before they’ll cover medical care, a prescription or a ...

Add Yahoo as a preferred source to see more of our stories on Google. A screen displays the logo fro Cigna Corp. on the floor at the NYSE in New York (Reuters) - Health insurer Cigna Group said on ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications. UnitedHealthcare, CVS Health's Aetna and dozens of ...

BOSTON (SHNS) – State insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements for “many routine and essential” health care services, Gov. Maura ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

Forbes contributors publish independent expert analyses and insights. Richard Menger is a neurosurgeon and a political scientist. You have worked for your company for 15 years. You suffer from chronic ...

Medicare Advantage (MA) insurers that impose prior authorization requirements on doctors in accountable care organizations (ACOs) should have to get them pre-approved by CMS, Sen. Sheldon Whitehouse ...