In 2023, there were nearly two prior-authorization determinations per Medicare Advantage enrollee, on average, compared with about one prior-authorization review submitted per 100 traditional Medicare ...

Health systems have to take responsibility for the broken prior authorization process and stop deferring action to payers, according to Jeff Balser, CEO of Vanderbilt University Medical Center. “A lot ...

Botox first became a household name for its ability to turn back the clock on facial aging. However, if you are considering Botox for cosmetic reasons and expecting Medicare coverage, you’ll be ...

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...

The Centers for Medicare and Medicaid Services has selected the six technology companies that will administer artificial intelligence-powered prior authorization programs for Medicare, STAT has ...

We collaborate with the world's leading lawyers to deliver news tailored for you. Sign Up for any (or all) of our 25+ Newsletters. Some states have laws and ethical rules regarding solicitation and ...

The lawmakers argue the CMS innovation center model, which will implement AI-backed prior authorization for some services in six states, will add red tape and limit access to care. The bill, called ...

While the AHA has called on CMS to rethink its plan to add prior authorization requirements to traditional Medicare, some argue that the program is due for some utilization management. CMS has sparked ...

U.S. health regulators sent warning letters Wednesday to 18 websites selling counterfeit or unapproved versions of Botox and similar injectable drugs commonly used to smooth wrinkles. The Food and ...

Botulinum toxin, commonly called Botox, is used to temporarily reduce wrinkles by paralyzing facial muscles. While it is considered safe, unapproved injections or counterfeit injections can come with ...

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 ...

A Twin Cities spa owner without a state nursing license has been giving cosmetic injections to clients, according to a criminal complaint that includes allegations she was buying black market Botox ...