Starting in 2026, new CMS rules aim to make prior authorization faster, more transparent, and fully electronic. These changes will require payers to use standardized APIs, meet strict response ...

A new CMS rule effective January 1, 2026, shortens standard prior authorization decisions to seven days and expedited ones to 72 hours, while requiring specific denial reasons. At the same time, ...

Insurers have eliminated 11% of prior authorization requirements across a range of medical services since June, representing 6.5 million fewer prior authorizations for members, according to an ...

The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for pharmaceuticals. Through the Interoperability Standards and Prior Authorization for ...

While artificial intelligence solutions can reduce administrative burden in prior authorizations and billing, organizations are reporting increased transaction volumes and higher costs, according to a ...

In June of 2025, health plans made a series of commitments to improve prior authorization. On Tuesday, insurer advocacy organization AHIP and Blue Cross Blue Shield Association gave their first update ...

Medicare Advantage plans would have to respond to urgent prior authorization requests for medications within 24 hours, and standard requests within 72 hours, under a proposed rule from the Centers for ...

Have you ever walked into the pharmacy and been told that your prescription requires a prior authorization? But your healthcare professional prescribed something for you, and you brought in your ...

A new proposed rule from the Centers for Medicare and Medicaid Services would reduce the required response time to Medicare Advantage prior authorization requests for medications to 24 hours and ...

At House hearings on Thursday, HHS Secretary Robert F. Kennedy Jr. downplayed the nation's massive measles outbreaks and defended the expansion of prior authorization into traditional Medicare under ...

A PEACE OFFERING — The White House is mending fences with some of the loudest supporters of Robert F. Kennedy Jr.’s Make America Healthy Again movement, POLITICO’s Cheyenne Haslett reports. After a ...