Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial intelligence tools.

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

Some Medicare recipients are set to experience a new “prior authorization” measure as the Centers for Medicare & Medicaid Services (CMS) trials its much-discussed “Wasteful and Inappropriate Service ...

Next year, Texas will be one of six states participating in a Medicare pilot program that uses artificial intelligence to review certain patient service requests to reduce fraud, waste and abuse.

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 ...

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 ...

Cigna is the latest health insurer to roll back prior authorization requirements, announcing Thursday that it will no longer require the approvals for nearly 25% of medical services. Cigna plans to ...

Zack Sigel is a writer and editor based in New York City. He has been managing editor at Policygenius and M1 Finance, where he led teams specialized in writing about business and finance, and he has ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

Electronic health record providers are starting work that could transform how nursing homes grapple with prior authorization requests and length of stay determinations.

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...