Medicare Advantage prior authorization (PA) is the process you go through to get certain services and drugs approved before you receive them. The process can be frustrating, as it can take up to 14 ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. Over the last several years, prior authorization has become a ...

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The CMS will soon make it more difficult for providers in six states to get reimbursed in Medicare for certain medical procedures it has deemed “low value,” but some stakeholders worry it could lead ...

Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many older adults choose original Medicare ...

Medicare Advantage plans say it reduces waste and inappropriate care. Critics say it often restricts coverage unnecessarily. By Paula Span Slowly but steadily, Marlene Nathanson was recovering. She ...

Effective Jan. 1, the Trump administration will, for the first time in the 60-year history of Medicare, implement a pilot project in six states (with Ohio being one of them) that will use private, for ...