Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

For decades, Americans have endured a healthcare system where access to care is delayed not by clinical need, but by administrative demands with little benefit. Prior authorization, the process ...

Forty-eight insurers, including major players, pledged to reform prior authorization processes to improve patient care access. The initiative includes technology standardization, reducing PA ...

Urgent requests would require an answer in 24 hours, and standard requests in 72 hours ...

People walk inside a Medicare Services office in New York City. Reporter Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid ...

For the first time, more Medicare enrollees received their Medicare benefits through a Medicare Advantage (MA) plan last year than through Traditional Medicare. We saw first-hand at the Center for ...

Digital and privacy rights nonprofit Electronic Frontier Foundation is suing the Centers for Medicare & Medicaid Services ...

Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care -- for coverage denials, ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...

Major insurers have cut 11% of prior authorizations after committing to roll back the controversial processes last year, according to major trade groups. The reduction equates to 6.5 million fewer ...