The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and Inappropriate Service Reduction model.
A new analysis from KFF and Health Management Associates takes a dive into prior authorization practices for Medicaid managed care organizations. The study polled state programs on policies in place ...
The Office of Inspector General has released a report examining prior authorization patterns from seven managed care companies, and based on the findings is urging increased oversight of prior ...
Gov. Jared Polis ordered the Colorado Department of Health Care Policy and Financing to reinstate prior authorization for ...
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.
From prior authorization hurdles to quantity caps, insurance restrictions on antiemetics are common and inconsistent across plans, drugs, and states, new data show.
2025 FEB 28 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News-- Investigators publish new report on Managed Care. According to news reporting originating in Camden, New Jersey, ...
Therapists treating Medicaid enrollees in Colorado will have to get the state’s authorization to conduct more than 24 sessions with an individual patient in a year, as the department overseeing the ...
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