Major U.S. health insurers, including UnitedHealth, CVS Health, Humana, and others, will implement standardized prior authorization data and submission requirements for common medical services ...

The approach will be used for medical services that are commonly subject to prior authorization, such as orthopedic surgeries ...

Drugs were left out of a 2024 rule streamlining prior authorizations, including by making decisions electronic and requiring ...

Roughly 50 insurers signed an AHIP (formerly America’s Health Insurance Plans) and Blue Cross Blue Shield Association commitment to standardize electronic prior authorization across most medical ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for ...

The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for ...

A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare ...

Wash., found procedures in the state that were previously approved within around two weeks now take four to eight weeks to be ...

For decades, Americans have endured a healthcare system where access to care is delayed not by clinical need, but by administrative demands with little benefit. Prior authorization, the process ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

Major U.S. health insurers, including UnitedHealthcare, CVS Health/Aetna, Humana, and others, will implement a single national standard for prior authorization submissions. The initiative aims to ...