Medicare Advantage plans use prior authorization to manage health care use. In recent years, these practices have come under intense scrutiny from policy makers. Using beneficiary enrollment data and ...

She soon realized getting it back was not straightforward. Deborah Finley, 50, of Lodi, California, said her weight started ...

One in three people get hit with a denial of coverage, but there are smart and effective ways to appeal.

Over four consecutive days in January, Margaret Hvatum ran a 5K, a 10K, a half-marathon, and a full marathon. The 70-year-old ...

Delaware is using funding from last year's Republican budget law to launch a first-of-its-kind effort to standardize and ...

She uses a large syringe to draw the medicine from a vial and loads the syringe into a plastic apparatus that looks like a ...

A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and ...

After switching Medicare Advantage plans, a woman with a weakened immune system got tangled in the preapproval process, which ...

Margaret Hvatum ended up in the hospital after her insurer denied coverage of a medicine she relies on to boost her immune ...

The letter to the CMS from Democrats is the latest salvo from lawmakers concerned that WISeR is delaying care to Medicare ...

Medicare had previously eschewed the practice — also known as prior authorization — which requires patients or someone on ...

Dr. Debra Shapiro and her staff spend hours in their Cambridge practice each week asking permission from insurers to prescribe their primary care patients certain medications and procedures. The ...