The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...

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

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual ...

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 ...

UnitedHealthcare, facing a storm of backlash from docs over its decision to implement a policy that would require prior authorization for some surveillance and diagnostic colonoscopies, is pushing ...

Physicians groups on January 17 hailed a new federal rule requiring health insurers to streamline and disclose more information about their prior authorization processes, saying it will improve ...

In an effort to soften the payer/provider relationship, many large health insurers are rolling back on prior authorizations. UnitedHealthcare (UHC) is the latest to cut back on its prior authorization ...