A new federal law is changing how certain public-sector retirees manage their healthcare costs, particularly in how Social ...

Under the Medicare Drug Price Negotiation Program, the HHS secretary negotiates directly with manufacturers on the prices ...

The U.S. District Court for the District of Maine recently dismissed two separate suits alleging that health plans’ coverage ...

Prior authorization, a process requiring healthcare providers to obtain approval from insurance plans before certain medications, medical services, or procedures can be administered, is a significant ...

Rep. Dr. Greg Murphy (R-N.C.) hopes his personal ordeal with prior authorizations will help inspire Congress to act.

By simply entering an order for a procedure into an electronic health record (EHR), AHN can now receive prior authorization from payers without any other human intervention, thanks to Humata’s ...

According to the KFF’s report of 2024 Medicare Advantage plans, 36% of individual plans and 88% of Special Needs Plans (SNPs) included some form of transport coverage. As private insurers ...

If a person has diabetes, Medicare covers one annual eye exam for diabetic retinopathy. This exam must be performed by a doctor or healthcare professional who is legally allowed to conduct it in ...

Dr. Oz, no ordinary TV star, was appointed as the new administrator for the federal government’s Centers for Medicare and Medicaid, and was recently sworn in — in the Oval Office, no less!

The new law puts deadlines on prior authorization decisions and puts ... which puts checks on the influence AI has in health care decision-making. He's joined by Rachel Lawlor, seated right ...

Pamphlets about using PrEP (pre-exposure prophylaxis) medication to prevent HIV at Prism Health North Texas ... insurance companies from requiring prior authorization for PrEP and ensure ...