Prior authorization was a hot topic in 2025, from insurers pledging reforms to a Medicare pilot on the horizon. Here are five of the biggest stories on prior authorization from 2025: 1. Payers have ...

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 ...

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 ...

If you’ve ever waited days, weeks or months for your doctor to get the green light from your insurance company before moving forward with treatment, you’ve likely felt the sting of priorization. And ...

I would like to request an enhancement to the NATS Server Auth Callout flow for WebSocket clients. This makes it impossible to reuse an existing web session (cookie-based auth) in Auth Callout without ...

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 ...

Hi, friends, being AI enthusiast, I'm an MBA, CEO and CPO who loves building products. I share my insights here.) Hi, friends, being AI enthusiast, I'm an MBA, CEO and CPO who loves building products.

Many private health insurers require medical providers to get approval before administering treatment, sometimes resulting in delayed or denied care for patients. Now, that tactic, known as prior ...

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 ...

A CMS pilot program that would add prior authorization for some traditional fee-for-service Medicare services has come under increased scrutiny by some members of Congress, including a call to pause ...

Prior authorization has become a hot-button issue in health care, and the National Council of Insurance Legislators will tackle the issue at its annual meeting in November. A draft of NCOIL’s Prior ...

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