Prior authorization can feel like a roadblock between you and the care you need, but new rules and technology are aiming to change that. From faster decision timelines to AI-powered tools that cut ...

Prior authorization and claims management remain some of the biggest bottlenecks in healthcare, delaying care and straining provider resources. With new CMS initiatives, payer technology upgrades, and ...

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

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

A pilot program in Arizona and five other states uses AI to review Medicare claims and it's hurting patients, Sens. Mark ...

AI is reducing administrative burden for hospitals and providers, but it is not always leading to lower costs. That's the ...

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

Every year, millions of prior authorization requests are fully or partially denied, but fewer than one in 1,000 ever appeal ...

Gov. Andy Beshear vetoed several health-related bills during the veto recess, but the Kentucky General Assembly overrode them during the last two days of the 2026 legislative session, April 14-15.

As artificial intelligence (“AI”) continues to be deployed in new use cases, state legislatures are considering measures to ...

Atropos Health, the world’s largest creator of real-world evidence (RWE) for clinical decision making, today announced the ...