Prior authorization forces doctors to spend 13 hours a week fighting insurers. New federal rules are changing that. Here's ...

Standing Policies Help Alleviate Administrative Burdens for More Than One Million Health Plan Members SAN DIEGO, April 14, 2026 /PRNewswire/ -- As part of an AHIP announcement April 7 outlining ...

Each prior auth transaction costs practices between $20 and $30 ...

The feds have AI reviewing whether claims through traditional Medicare are 'medically necessary' — upending longstanding ...

Issued Friday, the proposed rule also would require full disclosure of claims denials and appeals outcomes, according to a ...

Drugs were left out of a 2024 rule streamlining prior authorizations, including by making decisions electronic and requiring ...

HHS is proposing to adopt certain HL7 FHIR standards and implement specifications for transactions related to prior ...

The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for ...

A 2024 CMS rule now requires payers, including Medicare Advantage plans, Medicaid, CHIP and ACA exchange carriers, to publicly report prior authorization metrics for the first time. The public ...

CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule ...

Doctors in multiple states report unpaid claims and care delays under the new federal program, as a lawsuit seeks answers about AI algorithms and data security.

The Electronic Frontier Foundation is seeking more information on the government’s agreements with participating vendors, along with records related to any evaluations on accuracy, bias or ...