Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

An insurance company often requires this type of preapproval for certain services, procedures, prescription medications, and medical supplies. Your healthcare team can often help you navigate this ...

Whether you're filling a prescription or scheduling a procedure, chances are you've been asked whether you have prior authorization. By learning to navigate prior authorization and what steps to ...

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

Many physicians believe prior authorization gets in the way of sound patient care. New reforms from the insurance industry aim to address these challenges. Will they make a difference? You learn a lot ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

Why do I need a prior authorization for something that I am already prior-authorized to take? If my doctor says that they want me on a medication, why does my insurance have another say in that?” — ...

The Centers for Medicare and Medicaid Services has announced a prior authorization program pilot for original Medicare. The six-year voluntary Wasteful and Inappropriate Service Reduction Model (WISeR ...

Democrats are raising concerns about a new CMS pilot program testing prior authorization requirements, which make patients get their health plan’s approval before receiving certain services, in ...

A group of House Democrats is seeking answers from CMS Administrator Mehmet Oz, MD, regarding a new initiative that will add prior authorization for some traditional fee-for-service Medicare services.