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

Beginning Jan. 1, 2026, 17 medical procedures will require prior authorization for patients under the traditional Medicare ...

WASHINGTON -- Physician groups are hoping Medicare will change its mind about implementing new prior authorization requirements for two outpatient spinal procedures beginning July 1. In a final rule ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor ...

Several health insurers are extending prior authorizations for elective services that have been canceled or deferred because of COVID-19. Blue Cross and Blue Shield of Minnesota shared with Becker’s ...

The healthcare industry is on the brink of a transformative shift in the way prior authorizations are managed. Traditionally, prior authorizations have relied heavily on an attestation model, where ...

Many health systems and patients have struggled with prior authorization procedures. Prior authorization practices are staying in the spotlight. Health systems are looking for payers to do more to ...

UnitedHealth has rescinded a plan to require prior authorization for colonoscopies and other endoscopic procedures, following backlash from physician groups. UnitedHealth, which operates the biggest ...

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 ...

Rep. Lois Frankel said she is pushing back against a movement to add prior-authorization requirements to Medicare and to use ...

The controversial prior authorization policy for colonoscopies that UnitedHealthcare wanted to put into effect today will not take place, the company said last night in a statement. Instead UHC wants ...

Many physicians and practices say prior authorization is a major administrative burden and have urged lawmakers to institute reforms to the process for commercial and public payers. Nearly 97% of ...