States target health insurers’ ‘prior authorization’ red tape

The process Marks encountered is called "prior authorization," or sometimes "pre-certification," a tool insurers ... in 13 states, including Missouri. A 2022 survey of 26 health insurance plans ... Read More

Senate report scrutinizes Medicare Advantage prior authorization denials for post-acute care services

A report released Oct. 17 by the Senate Homeland Security Committee’s investigative subcommittee scrutinizes some of the nation's largest Medicare Advantage insurers for their use of prior ... Read More

Use of Prior Authorization Up in Medicare Advantage Plans, Senate Report Finds

Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care -- for coverage denials, ... Read More

How UnitedHealthcare is transforming the prior authorization process for patients and providers

UnitedHealthcare is reducing prior authorization requirements with new initiatives to ease administrative tasks and other challenges. Read More

AMA adopts new prior authorization reform policies

The policies address what AMA sees as the need for greater oversight of health insurers' use of prior authorization controls. Jeff Lagasse, Editor Improving the Patient Financial Experience Throughout ... Read More

Humana CEO looks to boost automated prior authorization approvals

There's way more abrasion between the providers and the health insurance ... some of the prior authorization tenets in the Improving Seniors’ Timely Access to Care Act. States have also created ... Read More

Prior authorization and Medicare Advantage: 6 things to know

KFF published an Aug. 8 report breaking down key statistics on Medicare Advantage patients and prior authorization based on data submitted by Medicare Advantage insurers to CMS for 2019 through 2022. Read More