Strengthen your financial backup. Even with Medicare coverage, unexpected out-of-pocket expenses can pop up. Earn as much as ...

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...

Cigna's Evernorth division is rolling out a rebate-free model for its pharmacy benefit manager, Express Scripts—meaning one of the industry's "Big Three" is moving away from the oft-criticized ...

The American Hospital Association is urging CMS to delay its Medicare prior authorization pilot — the Wasteful and Inappropriate Service Reduction initiative — by at least six months. “This timeframe ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

A breast cancer diagnosis should trigger immediate action. But for many patients, the journey to treatment begins with delays, often caused by outdated prior authorization (PA) processes. Designed to ...

Surescripts®, the nation's leading health intelligence network, today announced a major expansion of its Touchless Prior Authorization technology, now reaching more than 76,000 prescribers across the ...

Getting your Trinity Audio player ready... Therapists treating Medicaid enrollees in Colorado will have to get the state’s authorization to conduct more than 24 sessions with an individual patient in ...

A CMS pilot program that would add prior authorization for some traditional fee-for-service Medicare services has come under increased scrutiny by some members of Congress, including a call to pause ...

The program, called WISeR, aims to reduce wasteful spending and fraud in the Medicare system. Doctors and Democrats have raised concerns that the pre-approval process could delay or deny necessary ...

As congressional Democrats and Republicans battle over how to avert a potential government shutdown, another issue -- reining in prior authorizations -- remains on both parties' radar screens, ...

CLEVELAND, Ohio — A new Medicare pilot program, the Wasteful and Inappropriate Service Reduction (WISeR) Model, is set to launch next year in Ohio and five other states, potentially changing how older ...