UnitedHealth Group and CVS Health have standardized data and submission rules for more than half of their prior ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

Christy Carlson Romano is fighting her insurance to cover a cancer scan. Here's what to do if you face the same fight.

Prior authorization is a double-edged sword in healthcare — designed to control costs but often delaying care. New CMS rules and insurer commitments aim to streamline the process through electronic ...

Blue Cross Blue Shield of Massachusetts ("Blue Cross") today announced that the use of its new online preapproval tool has ...

Prior authorization has become one of the clearest points where administrative complexity directly affects patient care. For ...

Major reforms to prior authorization are coming in 2026, with CMS, HHS, and industry leaders pledging to simplify and speed the process. New federal rules will mandate FHIR-based APIs, tighter ...

High-deductible plan and insurance denied your scan? Here's what Romano's story reveals about your 2026 appeal rights.

Insurance denied your test or scan? The 2026 rules give you more tools to fight back than ever. Here’s the exact playbook to ...

PSG’s research found that payers are placing more attention on specialty drugs covered under the medical benefit, showing ...

Justin Sullivan, accessed via A rumor that the state of California provides free "sex-change procedures to homeless illegal ...

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and ...