As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use ...

Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial ...

More than 50 major insurers have pledged to streamline prior authorization starting in 2026, but providers remain cautiously optimistic and skeptical that the changes will truly reduce burden or ...

The start of the legislative session is just around the corner. Beginning in December, the Missouri Senate allows senators to ...

A CMS pilot program will require providers in six states to submit select Medicare services for AI-enabled prior authorization or post-service medical review.

Here are our top highlights from AAD 2025 that include safety of topical JAK inhibitors, climate impacts on skin health, ...

From the denials to critical updates on 340B and prior authorization, here is a look back at the trends and tactics that defined the revenue cycle in 2025.

Transparency, prior authorization, PBM reform and PBM offered genomics testing are some the trends Formulary Watched tracked ...

Soefje also discusses the growing role of pharmacists, technology, and comparative efficacy data in improving adherence, ...

How important, as we enter the holidays, to listen and remember to respect others by giving them our full attention.

Most non-emergency care at non-VA facilities requires the VA's approval before you schedule. This includes routine appointments, specialist consultations, procedures and diagnostic tests that aren't ...

Black Book Research Q4 flash survey shows health plans shifting from effort-based sourcing to KPI-backed operating models, ...