On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule[1] that would require ...

Medicare Advantage insurers fully or partially denied 7.4% of prior authorization requests in 2022, an increase compared to the previous three years, according to an analysis by health policy research ...

With CMS expanding its infrastructure for pre-payment review in traditional Medicare, here are five things practice leaders ...

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

US health insurers are advancing toward real-time prior authorization decisions by 2027 after reducing request volumes by 11%, eliminating 6.5 million transactions in 10 months. Insurers are working ...

SPRINGFIELD, Mo. (KY3) - Prior authorizations are standard this time of year as insurance changes. They’re essentially a request from your insurance asking for more information before agreeing to ...

A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare ...

There were 35.2 million prior authorization requests submitted to Medicare Advantage plans for healthcare services in 2021, and 2 million of those were denied, an analysis published Thursday shows.

Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

Drugs were left out of a 2024 rule streamlining prior authorizations, including by making decisions electronic and requiring ...

Prior authorization can delay patient care and cause frustration for physicians, who have to spend hours filling out paperwork every week. According to the most recent data from the Kaiser Family ...

A new study shows that close to 53 million prior authorization requests were sent to Medicare Advantage (MA) plans in 2024, increasing from 2023 and far above the number required in traditional ...