Traditional Medicare, also known as original Medicare, has historically required little in the way of pre-authorization for beneficiaries seeking services; pre-authorization was typically the domain ...

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 ...

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 ...

The push to revamp prior authorization practices has picked up steam recently. Some physicians and other healthcare leaders have long been outspoken about the issues created by strict prior ...

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 ...

A new survey of physicians finds they are still facing burdens meeting prior authorization requirements despite a voluntary 2018 agreement among payer groups to reform the practice. The survey was ...

There is a good reason for health insurers to occasionally require prior authorization for medical treatment. If a doctor prescribes an unusual, experimental, or expensive medication or procedure, the ...

Prior authorization — in which a patient needs approval from the health plan before proceeding with a medical service — has long created a rift between payers and providers. It has gotten such a bad ...

Prior authorization is “wreaking havoc” on patient outcomes, physician burnout and productivity, a recent American Medical Association survey found. The survey was conducted in December and asked ...

Few readers would be surprised to read that Americans are dissatisfied with their health care coverage — an outrage that the December 2024 assassination of UnitedHealthcare CEO Brian Thompson arguably ...