Medicare Advantage plans could look dramatically different if a new law passes in the Senate. For years, seniors have complained about prior authorization ...

Berwick is a former administrator of the Centers for Medicare and Medicaid Services. He is a senior fellow for health policy and Ducas is the VP of health policy at the Center for American Progress.

Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

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 ...

Editor’s note: David Charles is a practicing neurologist and chief medical officer at the Alliance for Patient Access. The first draft of this piece was written by Amanda Conschafter, communications ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups. UnitedHealth, which operates the biggest ...

The bill would establish a standardized electronic prior authorization process for Medicare Advantage plans, and it could serve as a model for new rules for employer plans. U.S. Senate Chamber. Photo: ...

One physician is making the case that prior authorization for procedures should be reported to insurance plans as a CPT code—though that proposal has been withdrawn for now. Alex Shteynshlyuger, M.D., ...

Geisinger Health Plan and software company Cohere Health are teaming up to simplify the prior authorization process and reduce provider burden. Through the deal, Danville, Pennsylvania-based Geisinger ...

Prior authorization will become less of a hassle for physicians in Blue Cross Blue Shield of Michigan’s network, BCBSM officials hope, as they roll out an effort to relax about 20% of prior ...

An insurance company often requires this type of preapproval for certain services, procedures, prescription medications, and medical supplies. Your healthcare team can often help you navigate this ...