The Centers for Medicare & Medicaid Services (CMS) has been using prior authorization for selected Hospital Outpatient Department (OPD) services ...

The Centers for Medicare and Medicaid Services (CMS) has implemented prior authorization requirements for certain traditional ...

Forty-eight insurers, including major players, pledged to reform prior authorization processes to improve patient care access. The initiative includes technology standardization, reducing PA ...

To combat growing criticism of prior authorization delays by payers, Centers for Medicare & Medicaid Services finalized a rule Wednesday that requires health plans to send prior authorization ...

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.

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...