Michigan's Collaborative for Type 2 Diabetes (MCT2D), a statewide population health collaborative quality initiative, analyzed nearly 1,000 physician-submitted patient case summaries and needs ...

UnitedHealth's newly returned CEO, Stephen Hemsley, will likely face investor scrutiny over the largest U.S. health insurance ...

The Pharmacy Benefit Manager (PBM) Transparency Act bans spread pricing, incentivizes PBMs to pass 100% of the rebates they ...

A new survey reveals widespread consumer frustration with prior authorization, highlighting the need for urgent reform in ...

Preauthorization is about to enter the lives of many seniors who have chosen traditional Medicare over MA, write former CMS ...

These changes apply to policies issued, reissued or altered on or after Dec. 31, 2026. So far, close to half of all U.S. states and the District of Columbia have passed prior authorization reform ...

The Centers for Medicare and Medicaid Services will be implementing prior authorization requirements for certain traditional fee-for-service Medicare services in six states, including Oklahoma ...

The Centers for Medicare and Medicaid Services (CMS) will implement prior authorization requirements for certain traditional fee-for-service Medicare services in six states starting next year.

As of today, Optum Rx is nixing reauthorization requirements for more than 60 additional medications. | The PBM giant's list of drugs includes products for behavioral health, HIV, dry eye disease ...

The Centers for Medicare & Medicaid Services announced a new Innovation Center model aimed at helping ensure people with Original Medicare receive care.