A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.

Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial ...

Health insurance companies are expected to hold to their promises in 2026 to “streamline, simplify and reduce” prior ...

Ahead of HIMSS26, Sairohith Thummarakoti of Texas A&M University–Kingsville previews his talk on how agentic AI and low-code ...

Beginning Jan. 1, 2026, 17 medical procedures will require prior authorization for patients under the traditional Medicare ...

The requirements will make exchanging health data more efficient and reduce administrative burden. Today CMS finalized the Interoperability and Prior Authorization Final Rule, continuing its efforts ...

Providers are betting on artificial intelligence to ease the pain point of prior authorization, a new survey shows. Cohere Health, which provides clinical intelligence to insurers and risk-bearing ...

Initially meant to protect patients from unnecessary procedures, prior authorizations have shifted towards being a cost containment strategy for health payers. This shift is causing significant ...

Prior authorization is overused, and existing processes present significant administrative and clinical concerns. That is why the AMA is fixing prior authorization by challenging insurance companies ...

A new North Dakota law that took effect Jan. 1 requires health insurers to respond to prior authorization requests in a timely fashion. The changes follow reforms seen elsewhere in the country, and ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...