Going to notify Medicare next. I'm forced to use Express Scripts, which has been a ... after getting the new prescription because of prior authorization issues. Dr sent the prescription in on ...

The rebate game played by drug makers and pharmacy benefit managers limits optimal biosimilar competition. As a result, U.S.

You may also need pre-approval, or prior authorization, for coverage of certain care. Prior authorization is a review of a requested health care service by your regional contractor to see if ...

There is a tendency to overlook the multiple factors and stakeholders that contributed to the Rx opioid crisis. This includes ...

Survey reveals 86% of physicians frustrated with prior authorizations hindering patient care. Find out the common challenges and desired changes in the process ...

Opens in a new tab or window Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care ...

The policy, CMS-1717-FC from the federal government, requires that patients with Medicare receive prior authorization to undergo these surgical procedures at hospital outpatient surgery departments.

The three largest Medicare Advantage insurers have dramatically increased prior authorization requirements and denials for post-acute care, often using algorithms, to enhance profits, a new report ...

The largest Medicare Advantage insurers have prioritized profits over patient care by increasing the use of prior authorization in recent years to frequently deny post-acute care services to older ...

The policy, CMS-1717-FC from the federal government, requires that patients with Medicare receive prior authorization to undergo these surgical procedures at hospital outpatient surgery departments.