The Trump administration has established a pilot program to expand prior authorization requirements within traditional Medicare, one of the most significant shifts in how the system processes medical ...

A new Medicare pilot program will require prior authorization for certain medical procedures, using AI to approve or deny coverage.

To control costs, nearly all health insurers use a system called prior authorization, which requires patients or their ...

Prior authorization requirements have been criticized for creating red tape, delaying care and denying services that should have been covered.

The New Mexico Office of Superintendent of Insurance urges all health insurance consumers to actively monitor the status of any prior authorization requests submitted on their behalf. New Mexico law ...

For decades, Original Medicare has been known for offering relatively few hurdles when it comes to accessing outpatient ...

Like millions of older adults, Frances L. Ayres faced a choice when picking health insurance: Pay more for traditional Medicare, or opt for a plan offered by a private insurer and risk drawn-outfights ...

Prior authorization is similar to how private insurers operate, often resulting in a delay or denial of treatments ...

Artificial intelligence is reportedly making its way into a traditional Medicare pilot program that six states, including Oklahoma, will test out.

They often deny coverage via snail mail. Here’s what happened when my family got a note like that 36 hours before cancer ...

Pre-authorizations have recently been introduced to certain hospital procedures conducted on an outpatient basis, under a new program that took effect on July 1, 2020.

United Healthcare, the largest health insurer in Colorado, will require prior authorization for most digestive procedures using a scope, though not for colonoscopies meant to screen for cancer.