These health care hurdles can stand in the way of getting treatment your doctor says you need. Here's what to know about how to deal with them.

Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

Prior authorization has been a bone of contention between payers and providers for some time now. Payers argue that it helps avoid unnecessary care and reduces costs, while providers say it creates ...

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 ...

Does Medicare require prior authorization? Medicare Advantage plans often require prior authorization. But these coverage reviews are rare for original Medicare. That distinction changes in 2026. Many ...

If there’s one thing healthcare providers can agree on, it’s that prior authorization management is a heavy administrative burden and only growing heavier. Decades ago, it was created to ensure care ...

It's no secret that burnout is a struggle across the healthcare industry, and the complex, time-consuming prior authorization process is one contributor. In fact, the U.S. Surgeon General addressed ...

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

They often deny coverage via snail mail. Here’s what happened when my family got a note like that 36 hours before cancer surgery. By Ron Lieber Disease doesn’t ask permission before invading a body, ...

The push toward healthcare interoperability and electronic prior authorization is meant to ultimately benefit patients and providers. However, providers will have to navigate these changes and ...

Remember that physician who wanted to develop a Current Procedural Terminology (CPT) code for prior authorizations? It hasn't happened yet, but he hasn't given up on it, either. In May, Alex ...

Health insurers are cautioning that prior authorization reforms could worsen health care cost increases, but a stream of doctors say the current system is plagued by administrative burdens and ...