A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

(L-R) White House AI and Crypto Czar David Sacks, Secretary of Health and Human Services Robert F. Kennedy Jr., President Donald Trump, Centers for Medicare and Medicaid Services Administrator Mehmet ...

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 ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Health insurance companies increasingly require medical providers to obtain approval before delivering the costliest forms of treatment to patients. This has helped curb wasteful expenditure but also ...

Earlier this year, the Centers for Medicare & Medicaid Services (CMS) announced an agreement with Medicare Advantage plans to lessen the use of prior authorization, but the agency also said it would ...

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 ...

The Biden administration released a proposal which, if finalized, would mandate Medicare Advantage (MA), Medicaid managed care, Affordable Care Act (ACA) plans and state Medicaid agencies implement ...

61% — The percentage of physicians who said that patients frequently abandon a recommended treatment due to prior authorizations in Medscape’s “They’re Awful and Impede Patient Care: Medscape ...