Over 6 million Americans on Medicare will now need to get prior authorization from AI for these 17 procedures

In 2023, there were nearly two prior-authorization determinations per Medicare Advantage enrollee, on average, compared with about one prior-authorization review submitted per 100 traditional Medicare ...

Prior authorization could stand between you and your doctor’s care and here's what it really means, how delays happen and what do if you’re denied

The idea behind it seems reasonable: Insurers want to ensure treatments are medically necessary before they pay for them. But ...
CNN

Insurers promised to ease a major patient pain point after executive’s murder. Here’s what’s happened

A year ago, the fatal shooting of a health insurance executive on a Manhattan sidewalk unleashed many Americans’ pent-up frustration with insurers’ delays and denials of care. UnitedHealthcare CEO ...
KUOW

Thousands of Washington state Medicare users could soon have claims denied by AI

Starting Jan. 1, traditional Medicare recipients in Washington state will face a new hurdle to get certain procedures covered — private AI companies that get paid based on how many claims they deny.
The New York Times

The Health Insurance Prior Authorization Memo That You Helped Write

Recently, we put together a template to help medical professionals explain a confusing process. Readers gave us very pointed feedback, so we updated it. By Ron Lieber Two months ago, I shared my tale ...
Morningstar

Rhyme Collaborates with Microsoft to Explore Touchless Prior Auth Capability at the Point of Care through Dragon Copilot

COLUMBUS, Ohio, Oct. 16, 2025 /PRNewswire/ -- Rhyme is excited to announce a collaboration with Microsoft to integrate with Microsoft Dragon Copilot to demonstrate that touchless prior authorization ...
The Denver Post

Colorado to reinstate prior authorization for Medicaid patients’ therapy

Getting your Trinity Audio player ready... Therapists treating Medicaid enrollees in Colorado will have to get the state’s authorization to conduct more than 24 sessions with an individual patient in ...
Columbus Dispatch

Medicare to require prior authorization for some procedures in Ohio starting in 2026

The program, called WISeR, aims to reduce wasteful spending and fraud in the Medicare system. Doctors and Democrats have raised concerns that the pre-approval process could delay or deny necessary ...
Healthcare Dive

Medicare prior authorization pilot raises concerns among providers

The CMS will soon make it more difficult for providers in six states to get reimbursed in Medicare for certain medical procedures it has deemed “low value,” but some stakeholders worry it could lead ...
MarketWatch

Plenful Unveils AI Suite to Automate Intake and Prior Authorization, Accelerating Patient Care and Slashing Admin Work by 75%

SAN FRANCISCO, Sept. 11, 2025 /PRNewswire/ -- Plenful, the leading AI workflow automation platform modernizing healthcare, today announced its Intake Authorization Management Suite. Built to end ...
KXAN

Plenful Unveils AI Suite to Automate Intake and Prior Authorization, Accelerating Patient Care and Slashing Admin Work by 75%

Already creating impact across top organizations like BioMatrix Specialty Infusion Pharmacy and Renown Health, Plenful's suite streamlines the entire intake authorization workflow from end-to-end ...