Prior Authorization – medicarereport.org

Thursday, November 6, 2025

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Eileen Cook September 25, 2025September 25, 2025 AI, CMS, Low-value services, medicare, Older Adults, Prior Authorization

AI Will Soon Have a Say in Approving or Denying Medicare Treatments

(By Lauren Sausser and Darius Tahir for KFF Health News) Taking a page from the private insurance industry’s playbook, the

Health Care Finance Health Insurance Prior Authorization

Eileen Cook August 26, 2025August 26, 2025 Healthcare Costs, Healthcare Finance, Prior Authorization

When hospitals and insurers fight, patients get caught in the middle

(By Bram Sable-Smith for NPR) Amy Frank said it took 17 hours on the phone over nearly three weeks, bouncing

CMS Legislative Update Medicare - General Prior Authorization

Eileen Cook August 12, 2025August 12, 2025 CMS, medicare, medicare legislation, Prior Authorization

Lawmakers question adding prior authorization for traditional Medicare services

(By: Andrew Cass for Becker’s Hospital Review) A group of House Democrats is seeking answers from CMS Administrator Mehmet Oz,

DHS -OIG HHS Medicaid Prior Authorization

Eileen Cook August 8, 2025August 8, 2025 DHS -Office of Inspector General, HHS, MCOs, Medicaid, Prior Authorization

Prior Authorization Process Policies in Medicaid Managed Care: Findings from a Survey of State Medicaid Programs

(By Jada Raphael, Elizabeth Hinton, Aimee Lashbrook, and Kathleen Gifford for The Kaiser Family Foundation Published: Aug 07, 2025) Medicaid

Health Care Finance Medicare - General Medicare Advantage Part D/Prescription Drugs

Eileen Cook July 30, 2025July 30, 2025 CMS, medicare, Medicare Advantage, Medicare Part D, Out-of-pocket costs, Premiums, Prior Authorization, Supplemental Benefits

Medicare Advantage in 2025: Premiums, Out-of-Pocket Limits, Supplemental Benefits, and Prior Authorization

(By Nancy Ochieng, Meredith Freed, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia Neuman for The Kaiser Family Foundation Published: Jul

CMS Emerging Health Issues Health Care - General Health Insurance HHS Prior Authorization

Eileen Cook July 25, 2025July 25, 2025 CMS, Health Insurance, Health Insurance companies, HHS, Prior Authorization

KFF Health Tracking Poll: Public Finds Prior Authorization Process Difficult to Manage

(By Grace Sparks, Julian Montalvo III, Shannon Schumacher, Ashley Kirzinger, and Liz Hamel for The Kaiser Family Foundation Published: Jul

Health Care Redesign Health Insurance Prior Authorization

Eileen Cook July 23, 2025July 23, 2025 Healthcare Finance, Healthcare redesign, Prior Authorization

Humana to cut prior auth requirements, introduce gold card program

(By: Jakob Emerson for Becker’s Hospital Review) Humana is accelerating its efforts to reform the prior authorization process through a series

CMS Health Care Finance Health Care Redesign HHS Prior Authorization

Eileen Cook June 25, 2025June 25, 2025 CMS, HHS, Prior Authorization

5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization

(By Lauren Sausser and Phil Galewitz for KFF Health News) Nearly seven months after the fatal shooting of an insurance

Health Care - General Health Care Redesign Prior Authorization

Eileen Cook June 23, 2025June 23, 2025 AHIP, Prior Authorization

AHIP is committed to streamline, simplify and reduce prior authorization

In committing to streamlining, simplifying, and reducing prior authorizations, “health plans are making voluntary commitments to deliver a more seamless

Affordable Care Act (ACA)Employer Healthcare Health Insurance Prior Authorization

Eileen Cook June 16, 2025June 16, 2025 ACA, Employer Health Insurance, Health Insuarnce, Healthcare Costs, Healthcare Finance, Prior Authorization

‘Not Accountable to Anyone’: As Insurers Issue Denials, Some Patients Run Out of Options

(By Lauren Sausser for KFF Health News) BRIDGEPORT, W.Va. — By the time Eric Tennant was diagnosed in 2023 with

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