Major health insurers are advancing efforts to standardize prior authorization requirements as part of an effort to simplify ...

Major US health insurers, including UnitedHealthcare, CVS Health/Aetna, Cigna, Humana, and several Blue Cross plans, will implement a standardized process for electronic prior authorization requests ...

Athenahealth and CoverMyMeds joined forces to streamline how patients receive prescriptions that require prior authorization from payers. Athenahealth integrated CoverMyMed’s electronic prior ...

On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule that would require faster ...

RadNet is a national radiology provider with 344 imaging centers employing 8,000 people and 500 radiologists. It has regional networks in New Jersey, New York, Delaware, Maryland, California and ...

Over 50 major U.S. health insurers, including UnitedHealthcare, Aetna, Cigna, Humana, and Blue Cross plans, will adopt a standardized framework for electronic prior authorization (ePA) across common ...

Prior authorization requirements cost the U.S. healthcare system an estimated $35 billion each year, and their overuse has triggered a backlash, stirring some policymakers into action. Whether these ...

The relationship between payers and providers has been historically contentious, with prior authorization being one of the biggest pain points. The process remains a heavily manual and costly burden ...

Prior authorization software company Cohere Health closed a $50 million Series B extension. Investment firm Deerfield Management led the round with support for venture capital firms Define Ventures, ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. Health insurer prior authorization has increased considerably in ...

For decades, Americans have endured a healthcare system where access to care is delayed not by clinical need, but by administrative demands with little benefit. Prior authorization, the process ...

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 ...