"Medically necessary" is often a four-letter word for patients.

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...

While there's a lot of buzz around prior authorization, it applies to fewer than 2% of claims. Prior authorization ensures care is both safe and aligned with the most up-to-date clinical guidelines.

The Centers for Medicare and Medicaid Services (CMS) recently announced the launch of a program that will require individuals on Medicare to obtain prior approval from the federal health insurance ...

Ask a provider what’s causing tension in their relationship with insurers and many will point to prior authorization, arguing that the practice creates administrative burdens and delays in patient ...

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

Highmark was among more than 50 health insurers who pledged Monday to speed up and slim down prior authorization, the process through which patients and their doctors must seek insurance approval for ...

The healthcare system’s reliance on prior authorization is wasting clinicians’ time, delaying care and worsening public distrust — and yet, payers show little urgency in fixing it, according to Dr.

Massachusetts regulators would eliminate many prior authorization rules, speed urgent approvals and form a working group to ...

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

Dr. Donald Macfarlane, M.D., Ph.D., served as chair of the Iowa Board of Health, and as a professor of medicine at the University of Iowa. The views expressed here are his own. In the past two decades ...