Medicare enrollees in Texas will soon be required to get prior authorization for certain medical services – and artificial intelligence will play a central role in those decisions. Beginning Jan. 1, a ...

Health systems have to take responsibility for the broken prior authorization process and stop deferring action to payers, according to Jeff Balser, CEO of Vanderbilt University Medical Center. “A lot ...

Aetna has announced it is integrating pharmacy prescriptions and medical procedures into a single clinical review to streamline the prior authorization process. The prior authorization bundles are for ...

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 ...

The Centers for Medicare and Medicaid Services has selected the six technology companies that will administer artificial intelligence-powered prior authorization programs for Medicare, STAT has ...

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A Fortinet FortiWeb path traversal vulnerability is being actively exploited to create new administrative users on exposed devices without requiring authentication. The issue is fixed in FortiWeb ...

A new bill from Democratic lawmakers seeks to repeal a controversial bill from the Centers for Medicare and Medicaid Services that would put artificial intelligence at the forefront of medical ...

We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...

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 ...

While the headaches and life-altering results of insurance pre-authorizations are not new to physicians or patients, lately things have been getting worse. Patients are sending more and more messages ...

The Wasteful and Inappropriate Service Reduction initiative from CMS is set to take effect Jan. 1, 2026, introducing new prior authorization requirements for select services. Here are seven things to ...