A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare ...

Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

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 ...

Prior authorization was rated a major burden by 32% of insured adults and the single greatest barrier by 34%, surpassing ...

US health insurers are advancing toward real-time prior authorization decisions by 2027 after reducing request volumes by 11%, eliminating 6.5 million transactions in 10 months. Insurers are working ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

A 2024 CMS rule now requires payers, including Medicare Advantage plans, Medicaid, CHIP and ACA exchange carriers, to publicly report prior authorization metrics for the first time. The public ...

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 ...

Urgent requests would require an answer in 24 hours, and standard requests in 72 hours ...

The fifth annual Abarca Forward conference, hosted by the pharmacy benefit manager (PBM) Abarca Health at its headquarters in ...

June 23 (UPI) --Major American insurers announced Monday that they have agreed to speed up and smooth out the processes involved with the reception and administration of health care by streamlining ...