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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 ...

Medicare providers participating in and payers offering Part C and Part D plans are facing increasing pressure to move into the 21st century, and the government is taking decisive steps to ensure this ...

The American Hospital Association and American Medical Association are among the groups applauding Medicare Advantage prior authorization reforms included in a final rule issued by CMS April 5. Editor ...

Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023, reflecting steady increases over the past few years as the number of MA enrollees has grown, according to ...

Prior authorization is a process that involves contacting a person’s Medicare provider to request coverage for a medical service, drug, or piece of equipment. If a person has Original Medicare (parts ...