Nearly 50 health insurers, led by AHIP and the Blue Cross Blue Shield Association, have committed to standardizing electronic prior authorization for most medical services. The move aims to speed up ...

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 ...

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

Major health insurers are advancing efforts to standardize prior authorization requirements as part of an effort to simplify ...

Your insurer is betting you won’t appeal — but research shows 1 million denials could have been overturned if patients pushed ...

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.

Alexandria now includes 33M precision Evidence-Based Findings (pEBF(TM)) growing to more than two billion studies in 2026, exceeding evidence-based findings in all public medical literature; Meta, ...

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