The N.C. Senate and House of Representatives differ on how to make health care more affordable and accessible, including prior authorization.

On March 24, 2025, the Federal Risk and Authorization Management Program (“FedRAMP”) announced a major overhaul of the ...

For the first time in 15 years, employment across the major health insurance companies fell last year, according to a Modern ...

Health plans often limit physical therapy to 20 or 30 sessions, even for people who may need months of treatment, multiple ...

The PBM is pivoting to a cost-based reimbursement model, which it says will reduce variation in how pharmacies are paid.

The PBM also announced that it will make the pharmacy experience simpler for consumers with chronic conditions by eliminating ...

Millions of Americans have started to or will soon see significant changes in their Social Security benefits as new laws and policies take effect in March 2025. Many individuals will be thrilled ...

Thanks to a team of pharmacists and pharmacy technicians, they are doing just that by tackling one of the biggest headaches in medical practice today: prior authorization. Physician burnout has been ...

The changes come as pharmacy benefit managers face scrutiny for how they require doctors and patients to seek its approval for certain treatments and drugs.

Optum Rx's new cost-based program uses an internal algorithm that leverages multiple available industry data sources, such as ...

“We better understand when those changes come,” McDaniel said ... House Bill 695 also reinstates prior authorization requirements for Medicaid recipients utilizing behavioral health ...

The next section, “Nourianz coupons and savings,” includes information about how much you can save by using an Optum Perks ... company may require prior authorization before it covers Nourianz.