In 2023, there were nearly two prior-authorization determinations per Medicare Advantage enrollee, on average, compared with about one prior-authorization review submitted per 100 traditional Medicare ...
The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...
Medicare is launching a new pilot program that will require prior approval for 17 health services using artificial ...
The MarketWatch News Department was not involved in the creation of this content. NASHVILLE, Tenn., Dec. 10, 2025 (GLOBE NEWSWIRE) -- RxLogic, a leading technology company for pharmacy benefit claims ...
NASHVILLE, Tenn., Dec. 10, 2025 (GLOBE NEWSWIRE) -- RxLogic, a leading technology company for pharmacy benefit claims processing that provides a SaaS-based platform of smart adjudication solutions, ...
The lawmakers argue the CMS innovation center model, which will implement AI-backed prior authorization for some services in six states, will add red tape and limit access to care. The bill, called ...
Starting or refilling a specialty medication can be a long and winding road with unexpected detours. Patients and prescribers can face delays due to extra administrative steps, while life sciences ...
Surescripts has released a new report detailing key drivers of clinician burnout, including administrative burdens and inefficiencies. According to a survey of prescribers and pharmacists, most agree ...
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 ...
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 ...
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