The proposed rule aims to improve prior authorization for prescription drugs by establishing and requiring electronic prior ...

The Centers for Medicare & Medicaid Services yesterday announced a new electronic prior authorization initiative as part of its Health Technology Ecosystem. CMS Administrator Mehmet Oz, M.D., said ...

New standard deadline: CMS will require NCPDP SCRIPT version 2023011 for all Part D e-prescribing starting January 1, 2028. Transition period set: From July 17, 2024 ...

Andrew Mellin, M.D., discusses Surescripts’ pilot program for prior authorization system, which pulls clinical data from EHRs ...

If you've spent years managing your health across MyChart, Express Scripts, and WellCare, you know the frustration of disjointed alerts and opaque prior authorization processes. But as of May 2026, ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

Prior authorization has long been a sticking point between payers and providers, with payers arguing that it’s necessary to control costs and ensure that care is medically necessary and providers ...

Prior authorization is the process by which your doctor must request approval from your Medicare plan before they can order a particular medication or medical service. Generally, Original Medicare ...

An insurance company often requires this type of preapproval for certain services, procedures, prescription medications, and medical supplies. Your healthcare team can often help you navigate this ...