The proposed rule could amplify the meaningful progress made by healthcare technology innovators and provide a more ...
The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for pharmaceuticals. Through the Interoperability Standards and Prior Authorization for ...
CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...
CMS has proposed a 2026 rule expanding prior authorization reforms to include drugs under both medical and pharmacy benefits, introducing electronic workflows, faster decision timelines, and greater ...
The proposed rule aims to improve prior authorization for prescription drugs by requiring electronic prior authorization, setting deadlines, and promoting transparency through annual reporting. The ...
Medicare Advantage plans would have to respond to urgent prior authorization requests for medications within 24 hours, and standard requests within 72 hours, under a proposed rule from the Centers for ...
Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...
Artificial intelligence has become healthcare’s favorite scapegoat, especially in insurance. Every denied claim, every delayed approval, every inexplicable “not medically necessary” response seems to ...
A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare Advantage prior authorization requests for medications to 24 hours and ...
Health insurers face a prior authorization prescription drug mandate similar to the rule imposed on claims, under a proposal released Friday by the Centers for Medicare & Medicaid Services. CMS is ...
UnitedHealthcare, CVS Health and Humana had the highest denial rates for long-term care requests, according to a report from ...
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