Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

The Connecticut State Medical Society is taking aim at the health insurance industry's practice of prior authorization this legislative session. Prior authorization, also known as "precertification" ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

It’s another busy day in my spine surgery clinic when my phone rings. Patients are waiting, but I’d be unwise to put off the caller: a physician calling from a health insurance company. This ...

Two key lawmakers reintroduced a bill on Wednesday that would essentially codify parts of a Biden administration rule that aims to streamline the use of prior authorization in Medicare Advantage. The ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

People walk inside a Medicare Services office in New York City. Reporter Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid ...

PA delays patient care, leads to treatment abandonment, and negatively impacts clinical outcomes, with 29% reporting serious adverse events. Physicians face increased healthcare costs and resource ...