Administrative costs are estimated to make up between 20 and 34 percent of US health care expenditures, roughly 1–4 percent of GDP. Academic and policy discussions generally characterize these costs ...

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 ...

If you’ve ever been a patient waiting—days, sometimes more than a week—for treatment approval, or a clinician stuck chasing it, you know what prior authorization feels like. Patients sit in limbo, ...

Centers for Medicare and Medicaid Services put forth a new set of rules to curb private insurance's use of prior authorization. These new rules will go into effect in 2026 and will impact care for the ...

U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. and Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz met with industry leaders to discuss their pledge to streamline ...

Payers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management. Like many others, I was drawn to be a doctor because I ...

UnitedHealth Group and Cigna are revamping their prior authorization processes as new federal regulations aiming to ease the burden on providers and patients loom. UnitedHealthcare will eliminate ...

WASHINGTON — Health and Human Services Secretary Robert F. Kennedy Jr. said Monday that the country’s largest health insurers have promised to take steps to streamline the often-criticized prior ...

The nation’s major health insurers are promising to scale back and improve a widely despised practice that leads to care delays and complications. UnitedHealthcare, CVS Health's Aetna and dozens of ...

When your doctor decides you could benefit from a particular test or procedure, your insurance company might require documentation to prove it's necessary before agreeing to pay for anything.