California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the ...

Utilization management tools, such as step therapy and prior authorization, are not only time consuming for patients, but they are a burden on providers and their practices due to the time and effort ...

Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment. Employer ...

Health plans frequently impose utilization management tools, such as prior authorization and step edits, in their prescription drug coverage policies. Their goal is to curtail inappropriate use and ...

The following is an excerpt from a 10-page special report, exclusive to ECT News Network, that looks at specific advantages of virtual infrastructure management and provides examples of ROI for ...