The Centers for Medicare & Medicaid Services May 13 announced 30 health care organizations have pledged early participation ...
CMS is launching a five-year Prior Authorization Demonstration for certain ambulatory surgical center (ASC) services beginning December 15, 2025, in 10 states, including Georgia, Florida, Tennessee, ...
Democrats in the House are making a push to roll back the Trump administration's new prior-authorization demonstration. A group of six Dems, led by Washington Rep. Suzan DelBene, have introduced new ...
In July, the Centers for Medicare and Medicaid Services (CMS) announced a six-year test of more aggressive prior authorization in Medicare’s traditional fee-for-service (FFS) program. CMS will conduct ...
Beginning in mid-December 2025, Medicare beneficiaries in ten states will face a new administrative layer before some common ambulatory surgical procedures — a move CMS says is intended to curb ...
When stakeholders think about prior authorization in the Medicare program, they usually focus on its use in Medicare Advantage (MA), and not how it is used in traditional Medicare. In fact, a few ...
A majority of physicians say the prior authorization process continues to negatively impact patient outcomes and employee ...
A government watchdog says the use of prior authorization keeps costs down, but that's unlikely to satisfy critics who say it hurts access to care. The Government Accountability Office (GAO), in a ...
House Democrats are sounding the alarm and demanding more information about a new Department of Health and Human Services (HHS) demonstration they say will increase red tape by adding prior ...
A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices. That's the word from the Centers for ...
A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices. That's the word from the Centers for ...
UnitedHealthcare plans to eliminate prior authorization requirements for 30% of services by the end of 2026.
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