WUSF Public Media

Medicaid has a new way to pay for costly sickle cell treatment: Only if it works

Medicaid is doing a novel payment system for the new, promising and expensive sickle cell treatment. It may become a model ...

Prior authorization could stand between you and your doctor’s care and here's what it really means, how delays happen and what do if you’re denied

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...
MobiHealthNews

Creating a blueprint for agentic AI in claims and prior authorization

Sairohith Thummarakoti, industry advisory board member at Texas A&M University–Kingsville, tells MobiHealthNews about his upcoming session at the 2026 HIMSS Global Health Conference & Exposition in ...
MarketWatch

Over 6 million Americans on Medicare will now need to get prior authorization from AI for these 17 procedures

Traditional Medicare in six states will soon feel more like privatized Medicare Advantage, using prior authorizations to determine what care can be covered for older adults. Starting in January, about ...
CNN

Insurers promised to ease a major patient pain point after executive’s murder. Here’s what’s happened

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...
STAT

Medicare picks tech vendors to run AI prior authorization pilot in six states

The Centers for Medicare and Medicaid Services has selected the six technology companies that will administer artificial intelligence-powered prior authorization programs for Medicare, STAT has ...
The New York Times

The Health Insurance Prior Authorization Memo That You Helped Write

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...
Hosted on MSN

CMS Administrator Dr. Oz on the future of Medicare and Medicaid, prior authorization requirements

Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz joins 'Squawk Box' to discuss Medicare reforms, implementing prior authorization requirements, the future of Medicaid, and more.
The Denver Post

Autism therapy providers sue Colorado’s Medicaid agency over prior authorization

Getting your Trinity Audio player ready... The Colorado Association for Behavior Analysis and 11 providers sued the state of Colorado on Tuesday, alleging that a requirement that they get advance ...
The Denver Post

Colorado to reinstate prior authorization for Medicaid patients’ therapy

Getting your Trinity Audio player ready... Therapists treating Medicaid enrollees in Colorado will have to get the state’s authorization to conduct more than 24 sessions with an individual patient in ...
Longmont Times-Call

Colorado to reinstate prior authorization for Medicaid patients’ therapy

Therapists treating Medicaid enrollees in Colorado will have to get the state’s authorization to conduct more than 24 sessions with an individual patient in a year, as the department overseeing the ...