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 ...

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 ...

A Surescripts-led pilot has shown that medication prior authorization can be processed in as little as 18 seconds without AI, sharply reducing denials and appeals. The program’s expansion across 20 ...

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 ...

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 ...

Zack Sigel is a writer and editor based in New York City. He has been managing editor at Policygenius and M1 Finance, where he led teams specialized in writing about business and finance, and he has ...

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 ...