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

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 ...

Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

Major health insurance providers have agreed to reduce the need for prior authorization — the requirement that patients must get approval from insurers before receiving certain treatments or risk ...

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use of prior authorization in Medicare. On the one hand, there is the effort ...

Berwick is a former administrator of the Centers for Medicare and Medicaid Services. He is a senior fellow for health policy and Ducas is the VP of health policy at the Center for American Progress.

Medicare Advantage plans could look dramatically different if a new law passes in the Senate. For years, seniors have complained about prior authorization ...

Editor’s note: David Charles is a practicing neurologist and chief medical officer at the Alliance for Patient Access. The first draft of this piece was written by Amanda Conschafter, communications ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups. UnitedHealth, which operates the biggest ...

Prior authorization will become less of a hassle for physicians in Blue Cross Blue Shield of Michigan’s network, BCBSM officials hope, as they roll out an effort to relax about 20% of prior ...

An insurance company often requires this type of preapproval for certain services, procedures, prescription medications, and medical supplies. Your healthcare team can often help you navigate this ...