Former congressman Michael Burgess opposes a White House executive order that ties U.S. drug prices to the artificially low, ...

Congress has attempted to pass “federal PBM reform.” Members of Congress have held numerous hearings related to PBMs and ...

A bipartisan bill introduced in the Senate and House aims to streamline the prior approval process for care for Medicare Advantage enrollees.

Navigating the healthcare system can be a complex and frustrating experience. Among the many challenges is prior ...

Lawmakers last week reintroduced the Improving Timely Seniors’ Access to Care Act, which aims to streamline prior authorization.

AMA leaders are “eager to meet” and “serve as a resource” on how to address burdensome prior authorization, AMA executive vice president and CEO James L. Madara, MD, told Mehmet C. Oz, MD, the new ...

Federal policymakers interested in opening up competition within healthcare should turn their attention toward the statues ...

Healthcare has seen a slew of proposed policy changes at the federal level in recent months. Here are the 10 most important federal policy updates for ASC leaders and physicians to know since May 1: 1 ...

On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing ...

Modern Healthcare points out from the new report, however, that the initial denials were often overturned, and insurers ended up paying nearly 97% of dollars requested. Also in industry news: Florida ...

Beneficiaries’ initial enrollment choices, whether active or passive, tend to have long-lasting implications because ...

The current prior authorization process in U.S. healthcare constitutes a crisis, according to Jesse Ehrenfeld, immediate past ...