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 ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

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 ...

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 ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

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 ...

The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for ...

In 2026, the Centers for Medicare and Medicaid Services (CMS) will expand prior authorization in the fee-for-service program through the Wasteful and Inappropriate Service Reduction (WISeR) Model.

Health and Law flat lay. Judge gavel, medicine and doctor coat on blue, background, top view. Medical malpractice, personal injury attorney. Prior authorization has caused significant frustration for ...

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining in prior authorizations -- remains on both parties' radar screens, ...