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, ...

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 ...

Prior authorization is no longer just an administrative hurdle for ASCs; it is a defining constraint on growth. As authorization requirements expand, policies shift and payer scrutiny intensifies, ...

Optum is introducing AI-powered prior authorization. Optum said the intelligent automation solution delivers timely decisions for providers to reduce delays, speed approvals and reduce repetitive work ...

The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services for several years as part of its broader effort to curb ...

Prior authorization is a major noncost barrier, affecting 69% of insured adults, with 34% citing it as their biggest challenge. Delays and denials from prior authorizations significantly impact mental ...

R1 RCM has launched a new tool designed to automate and streamline the prior authorization process at scale. The tool, called R1 Prior Authorization, manages the full authorization lifecycle through a ...

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 ...

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

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 ...

Elaine Chen, a national biotech reporter, is the co-author of The Readout, a newsletter about the business, science, and politics of biotech. Elaine Chen covers biotech, co-writes The Readout ...

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 ...