A new policy increased wait time for patients, but didn't speed up the move from hospital-based to outpatient-based operations. A new policy increased wait time for patients, but didn’t speed up the ...

Prior authorization delays and standardized codes that do not measure case variability are just two orthopedic policy ...

Medicare beneficiaries in 10 states will soon be participating in a new prior authorization program. The Centers for Medicare & Medicaid Services (CMS) is implementing a five-year demonstration ...

For beneficiaries in six states, AI could decide on some Medicare claims for non-emergency health care services.

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

Please provide your email address to receive an email when new articles are posted on . HHS and CMS recently announced insurers have pledged to voluntarily reduce prior authorizations. Questions ...

Prior authorization of drugs, diagnostic testing, or other medical services “is intended to ensure that health care services are medically necessary by requiring providers to obtain approval before a ...

"Medically necessary" is often a four-letter word for patients.

In this week’s edition of InnovationRx, we look at efforts to improve prior authorization, commercializing Bell Labs’ IP portfolio, a new billionaire from Caris Life Sciences’ IPO, a big funding round ...

Please provide your email address to receive an email when new articles are posted on . Patients who required prior authorization had increased costs in the year prior to TKA. Prior authorization was ...