Prior authorization (PA) is a widely used insurance mechanism intended to ensure cost-effective, evidence-based care. However, in practice, it often imposes significant administrative and clinical ...

California is one of 31 states that passed laws in 2025 limiting insurance companies’ use of prior authorization to approve ...

While the cost of health care remains the dominant worry among Americans, the process of obtaining prior authorization from insurers has become the most burdensome noncost barrier for insured adults ...

A look at the rise of prior authorization certified specialists (PACS)—and their value in improving patient access and outcomes. The healthcare industry constantly grapples with the challenge of ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. My 90-year-old uncle, a retired county employee, has had a ...

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...

New Medicaid prior-authorization rules have advocates in Connecticut concerned about patients losing access to their prescription drugs.

Prior authorization is no longer just an administrative hurdle for ASCs; it is a defining constraint on growth. As authorization requirements expand, policies shift and payer scrutiny intensifies, ...

Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Almost 8% of those requests were partially or fully ...

Nearly seven months after the fatal shooting of an insurance CEO in New York drew widespread attention to health insurers’ practice of denying or delaying doctor-ordered care, the largest U.S.

Physicians and other medical providers will tell you that prior authorization is out of control and has transcended any legitimate rationale.