A recent proposal to report prior authorization to insurance plans through CPT codes was withdrawn at the eleventh hour when its physician advocate made an unexpected discovery: For certain codes and ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...

Prior authorization has emerged as a flash point between payers and providers as the former tries to manage what they believe is waste in the system while the latter accuses payers of trying to deny ...

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 ...

Medicare Advantage plans' prior authorization rules and coverage criteria would become publicly available under a proposed rule issued Tuesday by the Centers for Medicare & Medicaid Services (CMS).

Health insurers covering more than 250 million Americans have unveiled a sweeping plan to streamline and reduce prior authorization requirements — a long-standing source of frustration and burnout for ...

In 2025 alone, doctors and legislators across the country have already introduced more than 100 pieces of legislation meant to reform prior authorization. The cumbersome approval process is a leading ...

The prior authorization process has been debated by physicians, hospitals, health plans and even the government for a number of years. What about this particular moment made it time to act and lean ...

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 ...

Three new studies highlighted the growing burden of prior authorization on both oncologists and patients. Findings from a survey of radiation oncologists, for instance, revealed that more than 80% ...