Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Ask a provider what’s causing tension in their relationship with insurers and many will point to prior authorization, arguing that the practice creates administrative burdens and delays in patient ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

The Centers for Medicare & Medicaid Services' (CMS) has recently demonstrated a focus on promoting patient care by removing unnecessary obstacles to prior authorization. Prior authorization is a payer ...

Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences. Many states have adopted or are ...

Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Almost 8% of those requests were partially or fully ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

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