Officials at Musk-led DOGE were given access to the inner workings of the Centers for Medicare and Medicaid Services (CMS), ...

Will your care be denied? Medicare Advantage insurers use prior authorization to manage utilization and lower costs. How does ...

Prior authorizations are the way MA managed care plans pre-approve some procedures before they’ll pay for them.

Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before ...

Insurers say they help lower patient costs by helping people avoid unnecessary or inappropriate health services.

Quinterno said laws trying to limit the scope of prior authorizations are trying to remove patients “caught up in a byzantine ...

House Republicans plan to reintroduce legislation that would reform how North Carolinians are affected by health insurers' prior authorization policies for treatments, medications and procedures. The ...

A new study published in JAMA Network Open has found that while procedural prescription denials curb immediate drug costs, some denials result in increased acute care utilization and costs, which ...

Medicare will continue to negotiate drug prices in 2025. (HealthDay News) — Medicare will soon negotiate prices for 15 more drugs as part of an effort to reduce costs for seniors and people with ...

A grievance through Medicare was begun 2 weeks prior & still no materials or cards. Unable to see doctors or fill medication & use over the counter benefits. I tried to help an elderly friend sign ...

Patients with MS, epilepsy, and Parkinson disease have to wait longer than those with back pain. HealthDay News — After being referred by their physician, Medicare patients wait an average of 34 ...

Medicare will only pay for the skilled nursing facility stay if you had at least a three-night inpatient stay in the hospital. There are a variety of reasons a health plan might deny a prior ...