Prior Authorization – medicarereport.org

Tuesday, June 24, 2025

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Seven Million People with Medicare Spend More Than 10% of Income on Part B Premiums – The Reconciliation Bill Could Drive the Number Higher
The Trump administration’s approach to PBMs, so far: 5 things to know
AHIP is committed to streamline, simplify and reduce prior authorization
A Closer Look at the Medicaid Work Requirement Provisions in the “Big Beautiful Bill”
CMS finalizes rule to trim premiums: 5 things to know

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

Health Care Redesign Health Insurance Legislative Update Prior Authorization

Eileen Cook June 10, 2025June 10, 2025 Health Insurance, Prior Authorization

Nebraska enacts prior authorization reform law

(By: Jakob Emerson for Becker’s Hospital Review) Nebraska Gov. Jim Pillen has signed the Ensuring Transparency in Prior Authorization Act,

CMS Health Care Redesign Medicare - General Medicare Advantage Prior Authorization

Eileen Cook May 1, 2025May 1, 2025 CMS, Healthcare Reform, medicare, Medicare Advantage, Prior Authorization

CMS weighing prior authorization reforms: Report

(By: Andrew Cass for Becker’s Hospital Review) CMS is considering proposals that would cut the number of procedures that are subject

Health Care - General Health Care Finance Health Insurance Prior Authorization

Eileen Cook February 13, 2025February 13, 2025 Health Insurers, Healthcare Costs, Healthcare Finance, Obstacles to Care, Prior Authorization

Montana Looks To Regulate Prior Authorization as Patients, Providers Decry Obstacles to Care

(By Mike Dennison for KFF Health News) HELENA, Mont. — When Lou and Lindsay Volpe’s son was diagnosed with a

Medicare Advantage Prior Authorization

Eileen Cook January 29, 2025January 29, 2025 Medicare Advantage, Prior Authorization

Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023

(By Jeannie Fuglesten Biniek, Nolan Sroczynski, Meredith Freed, and Tricia Neuman for The Kaiser Family Foundation Published: Jan 28, 2025)

Health Care - General Legislative Update Prior Authorization

Eileen Cook January 27, 2025January 27, 2025 Indiana, Prior Authorization

Indiana bill puts prior authorization in the crosshairs

(By Andrew Cass for Becker’s Hospital Review) An Indiana lawmaker has reintroduced legislation that would cap all prior authorization rates

CMS Health Care - General Health Insurance Medicare - General Prior Authorization

Arlene Sharp September 27, 2024September 27, 2024 CMS, medicare, Prior Authorization

Medicare Advantage Denials Increased Before the Implementation of New Prior Authorization Rules

By Julie Carter for Medicare Rights on September 26, 2024 KFF recently analyzed Medicare Advantage (MA) data on prior authorization,

Health Insurance Medicare Advantage Prior Authorization

Eileen Cook August 13, 2024August 13, 2024 Health Insurance companies, Medicare Advantage, Older Adults, Prior Authorization

7 payers cutting prior authorization requirements

(By Rylee Wilson for Becker’s Hospital Review) Several payers are scaling back their prior authorization requirements in an effort to

Medicare Advantage Prior Authorization

Eileen Cook August 7, 2024August 7, 2024 Denial Rates, Medicare Advantage, Medicare Advantage Prior Authorization, Prior Authorization

Medicare Advantage insurers ranked by prior authorization denial rates

(By Rylee Wilson for Becker’s Hospital Review) Medicare Advantage insurers denied 7.4% of prior authorization requests in 2022, according to

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