In Massachusetts, health plans are required by state law to collaborate with physicians to develop medical necessity guidelines used for prior authorization. Not only would abandoning prior ...

The challenge of ensuring that all patients have access to affordable, high-quality care will not be solved by setting up ...

On January 17, 2025, the U.S. Department of Homeland Security introduced a final rule modernizing the H-1B visa program. Key ...

Prior authorizations are the way MA managed care plans pre-approve some procedures before they’ll pay for them.

Will your care be denied? Medicare Advantage insurers use prior authorization to manage utilization and lower costs. How to ...

Understanding the reasoning and process of Medicare Advantage prior authorization can help you gain faster approval for a required prior authorization.

Insurers say they help lower patient costs by helping people avoid unnecessary or inappropriate health services.

House Republicans plan to reintroduce legislation that would reform how North Carolinians are affected by health insurers' prior authorization policies for treatments, medications and procedures. The ...

On January 22, 2025, the New York Assembly passed Senate Bill S929, titled the New York Health Information Privacy Act (New York HIPA). The act is ...

There are a variety of reasons a health plan might deny a prior authorization request or a medical claim. The service might not be covered by the health plan, or the health plan might require specific ...

Bruce A. Scott, M.D., president of The American Medical Association (AMA), said in a statement Witty’s vow to address prior authorization, but “improving the prior authorization process requires ...

I want Iowa law to require health insurers to respond to a prior authorization request in 20 minutes, not to delay it for seven days. Need a break? Play the USA TODAY Daily Crossword Puzzle.