Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care. This commentary discusses the current prior ...

Physicians surveyed by the AMA say that PA can cause care delays or force patients to abandon treatment. They warn denials could increase as insurers adopt AI to review claims. Physicians have long ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. On June 27, 2025, the Centers for Medicare and Medicaid ...

Rep. Mark Green (R-Tenn.) reintroduced a bill Thursday seeking to reform prior authorization requirements in Medicare, Medicare Advantage, and Part D prescription drug plans requiring only specialty ...

Prior authorization (PA) is a utilization management technique used by health insurers that requires providers to seek approval from the insurance plan before the plan will agree to pay for a covered ...

Health and Law flat lay. Judge gavel, medicine and doctor coat on blue, background, top view. Medical malpractice, personal injury attorney. Prior authorization has caused significant frustration for ...

When your doctor decides you could benefit from a particular test or procedure, your insurance company might require documentation to prove it's necessary before agreeing to pay for anything.

BRIDGEPORT, W.Va. — By the time Eric Tennant was diagnosed in 2023 with a rare cancer of the bile ducts, the disease had spread to his bones. He weighed 97 pounds and wasn’t expected to survive a year ...

The broader health insurance industry has announced a series of commitments to streamline, simplify and reduce prior authorization requirements across commercial, Medicare Advantage and managed ...