Offering a rare glimpse inside the hidden world of rejected insurance claims, new data shows a steady uptick among major ...

In a recent roundtable, the Department of Health and Human Services and executives from top insurance providers pledged to address longstanding concerns around prior authorizations, aiming to reduce ...

Becker’s reported on six developments in CMS and Medicare news affecting spine surgery and physicians. 1. Some fee-for-service spine procedures in traditional Medicare will have prior authorizations ...

Health insurers must provide speedier responses to prior authorization requests for certain medical treatments and services, ...

Sanjay Doddamani, MD, MBA, a former senior advisor to the Center for Medicare and Medicaid Innovation, and internist and ...

This is the “left shift” in healthcare. It means moving appropriateness away from bureaucratic checkpoints after a decision ...

Provider organizations have answered the Department of Health and Human Services’ (HHS’) call for deregulation suggestions with their policy change wish lists tackling topics from prior authorizati | ...

Physician burnout figures have dipped, but much work remains. The AMA offers a wealth of resources supporting professional satisfaction.

A bill intent on reforming the pre-authorization process in Delaware passed both chambers and is now under consideration from Gov. Meyer.

The Centers for Medicare & Medicaid Services July 15 issued a proposed rule ( that would increase Medicare hospital outpatient prospective payment system rates by a net 2.4% in calendar year 2026 ...

MOBILE, ALA.—Not long ago, Dr. Richard Menger, a neurosurgeon, was ready to operate on a 16-year-old with complex scoliosis.

Funneling money to for-profit companies by rewarding them for denying health care coverage through using unproven, manipulable AI models is not the answer. The Trump Administration is bringing prior ...