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 ...

Artificial intelligence will soon be used for prior authorization for certain Medicare services in Texas and five other ...

The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual ...

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 ...

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.

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But in practice, it often means delayed appointments, stalled medication ...

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.

CMS compliance deadlines and heightened cybersecurity expectations are accelerating payer interoperability and utilization management modernization while shifting vendor selection toward platforms ...