Tag: prior authorization requirements

Top-10-prior-authorization-updates-in-2023

10 Prior Authorization Updates in 2023 

In 2023, multiple entities, such as the Health Insurance Company and health Services Company, declared reductions in prior authorizations. Healthcare Media provided further details on this and additional updates related to prior authorizations in the healthcare sector reported this year. According to a November 13 report from the Medical Group Management Association, 89% of medical […]
Learn More
Advancing Prior AuthorizationThe Evolution in CMS Regulation

Advancing Prior Authorization: The Evolution in CMS Regulation

The Centers for Medicare & Medicaid Services (CMS) have embarked on a decisive move by enforcing a standard for Advancing prior authorization. In a conversation with the Senior Director of Utilization Management, we discussed the potential implementation and impact of this proposed mandate, slated for enactment in January 2026 The Predicament of Prior Authorization The […]
Learn More
medicare-suspends-prior-authorization-requirements-for-some-dme

Medicare Suspends Prior Authorization Requirements for Some DME

Prior authorization is no longer required for certain DME when it risks the health of the patient. The Centers for Medicare & Medicaid Services (CMS) has suspended the prior authorization requirements for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) when waiting for prior authorization would delay healthcare and risk the life or health […]
Learn More
x