Prior Authorization
American Hospital Association (AHA) resources on health care insurance prior authorization, the impact of insurers' delays and rejections on patients, and the cost of these delays to hospitals and health systems.
A Health Affairs study published Nov. 3 examined an increase in states banning prior authorizations in private insurance plans for opioid use disorder medications.
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address multiple concerns.
October 23, 2025Abe Sutton, JDDeputy Administrator and DirectorCenter for Medicare and Medicaid InnovationCenters for Medicare & Medicaid Services7500 Security BlvdBaltimore, MD 21244Re: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and…
The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure insurance plans adhere to the agencies’ health insurer pledge to reform prior authorization processes.
AHA supports the Administrations role in facilitating the health insurer pledge to reform prior authorization processes announced on June 23.
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The Centers for Medicare & Medicaid Services Innovation Center Aug. 12 released an FAQ on the Wasteful and Inappropriate Service Reduction Model, a six-year technology-enabled prior authorization program pilot.
The Centers for Medicare & Medicaid Services (CMS) July 31 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS final rule for fiscal year (FY) 2026.
The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization program pilot.
The Department of Health and Human Services June 23 announced an initiative coordinated with multiple health insurance companies to streamline prior authorization processes for patients covered by Medicare Advantage, Medicaid managed care plans, Health Insurance Marketplace plans and commercial…