Medicare Advantage insurers received about 46.2 million prior authorization requests in 2022, up from 36.5 million in 2021, according to a recent KFF report. Of these 46.2 million requests, 7.4% (3.4 ...

ALEXANDRIA, Virginia, April 28 (TNSgov) -- The American Physical Therapy Association issued the following news: In a win for APTA and other organizations fighting to reduce administrative burden, the ...

There were 35.2 million prior authorization requests submitted to Medicare Advantage plans for healthcare services in 2021, and 2 million of those were denied, an analysis published Thursday shows.

Medicare Advantage plans required prior authorizations about 125 times more often than regular Medicare in 2023, demonstrating the barriers MA patients face in accessing care. An analysis published by ...

The US Government Accountability Office (GAO) recently released a report on the Centers for Medicare and Medicaid Services (CMS)’s oversight of prior authorization criteria for behavioral health ...

In a recent opinion published in JAMA, health policy researchers reviewed the advantages and disadvantages of prior authorization in Medicare Advantage (MA) to identify key areas that need improvement ...

Prior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.

The CMS is once again tackling prior authorization in its new rule proposed Tuesday. Prior authorization, a process in which a physician must get the green light from an insurer for medication or ...

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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