State laws that ban insurance prior authorization for buprenorphine-a leading medication for opioid use disorder-may not help more patients stay in treatment for the recommended minimum of 180 days, ...

If you or someone you care about is exploring addiction treatment options, you may be wondering whether your state Medicaid coverage extends to virtual outpatient rehab. The short answer is: in most ...

A guide to Medicare coverage for breast cancer diagnosis and treatment, including cost differences between Original Medicare ...

For some independent cardiology practices, financial and operational stability may feel like a moving target as reimbursement policies and reporting requirements continue to shift. Larry Sobal, CEO of ...

Submit an appeal, even if you're worried you’ll lose. Yaver said that, based on the research set to be published in her book, Coverage Denied: How Health Insurers Drive Inequality in the United States ...

These health care hurdles can stand in the way of getting treatment your doctor says you need. Here's what to know about how ...

Semaglutide (GLP-1) drugs like Ozempic are designed to treat type 2 diabetes, but are widely known for their effect on weight loss. Credit: Shahrzad Rasekh / CT Mirror Groups representing low-income ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor prescribes an unusual, experimental, or expensive medication or procedure, the ...

Massachusetts insurance regulators unveiled sweeping prior authorization reforms that would scrap pre-approval requirements for "many routine and essential" health care services, Gov. Maura Healey ...

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 ...

Prior authorization (PA) is a utilization management technique used by health insurers that requires providers to seek approval from the insurance plan before the plan will agree to pay for a covered ...