Medicare is launching a significant new prior authorization initiative under the CMS Innovation Center’s Wasteful and Inappropriate Service Reduction (WISeR) model. Beginning January 2026, select ...

Starting January 1, 2026, Medicare Original will require an additional step for 17 specific services. This is a federal ...

Approval marks continued progress in expanding reimbursement pathways and accelerating access to advanced personal ...

Danielle Roman, PharmD, BCOP, discusses the challenges of accessing genomic test results and managing prior authorization in patient care for breast cancer.

The case of one Maine woman shows how prior authorization rules can block coverage for even simple, medically necessary care.

Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz, M.D., sought to make inroads with the bristling ...

Health insurers have long argued that prior authorization — when health plans require approval from an insurer before someone receives treatment — reduces waste and fraud.

According to the folks at Fidelity, a 65-year-old person retiring in 2025 can expect to spend $172,500, on average, on ...

EXCLUSIVE: Cancer patients, oncologists and advocates tell Rhian Lubin why the US health insurance system needs urgent reform, and is risking the lives of Americans fighting the disease ...

Too many are asking how to fit AI into their existing technology stack, where presumably it will act as a silver bullet for ...

Medicare prices are rising in 2026, but savvy seniors can save during open enrollment (and beyond) with these cost-cutting ...

Patients seeking access to oral acute myeloid leukemia (AML) medications face complex insurance approval processes that can ...