#prior-authorization

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www.npr.org
2 months ago
Health

Her insurer stopped approving her medicine that worked. Will a new state law help?

Patients struggle with insurance companies' prior authorization for necessary medications.
States are enacting legislation to address issues related to prior authorization processes. [ more ]
www.nytimes.com
2 months ago
Health

Opinion | What's My Life Worth?' The Big Business of Denying Medical Care

Prior authorization can create barriers to necessary healthcare treatment.
Insurance companies using prior authorization can impact patients' access to care. [ more ]
www.bostonherald.com
2 months ago
Public health

States target health insurers' prior authorization' red tape

Insurers use prior authorization to control costs and protect patients from unnecessary treatment, but it can be frustrating and interfere with care.
The Biden administration announced new rules to streamline the prior authorization process, and some states are considering additional legislation. [ more ]
www.bostonherald.com
3 months ago
Public health

What to do if your hospital drops your Medicare Advantage plan

More than half of Medicare-eligible people are enrolled in Medicare Advantage, but hospitals have been dropping these plans due to issues with prior authorizations and denials.
Hospitals and health systems in at least 11 states announced they would be out-of-network for some or all Medicare Advantage plans in 2024. [ more ]
MedCity News
3 months ago
Public health

CMS Finalizes Rule Streamlining Prior Authorization Process

The CMS has announced a new rule to improve the prior authorization process, saving $15 billion over 10 years.
The rule requires payers to send prior authorization decisions within 72 hours for urgent requests and seven days for non-urgent requests. [ more ]
Axios
3 months ago
Medicine

The gap in a new plan to speed health insurance authorizations

Medicare Advantage and state Medicaid programs have similar response time frames for drugs administered in a doctor's office or hospital.
Patient advocates and the health industry are pushing for faster prior authorization response times and improved coverage request processes for physician-administered drugs. [ more ]
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