The U.S. Department of Homeland Security has implemented a registration requirement for foreign nationals effective April 11, 2025. Failure to ...

CMS Rule 0057 requires health plans to develop and support FHIR-based APIs to enable electronic prior authorization (ePA). Whether return on this investment stops at ...

CMS finalized a key provision that holds Medicare Advantage insurers responsible for paying inpatient hospital admissions claims previously approved through the prior authorization process.

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Experts discuss effective strategies for navigating the prior authorization process to ensure timely access to third-line therapies for metastatic colorectal cancer (mCRC) and share any success ...

For patient advocates and health economists, cases like Ekirch's illustrate why prior authorization has become such a chronic pain point for patients and doctors. For 50 years, insurers have ...

Bipartisan lawmakers have introduced a bill that aims to more closely align Medicare insurers’ prior authorization denials with medical need, as determined by board-certified specialist physicians.

In addition to concerns about AI, the survey revealed concerns about delays in care, health care costs, and physician burnout. Most physicians surveyed expressed concern that health insurance ...

Several states are considering regulating how insurers can use AI in prior authorization. In January, a California law took effect that prohibits payers from making coverage decisions based solely on ...

Silna Health, which uses AI to manage prior authorization, benefit checks and eligibility verification, today announced it has raised $27 million in total funding. The company's $22 million Series ...

Silna Health's AI-powered platform slashes insurance approval times from weeks to hours, already helping over 50,000 patients access critical care NEW YORK, March 25, 2025--(BUSINESS WIRE)--Silna ...

4x faster trend analysis to identify utilization pattern changes and outliers "Health plans want to support providers in delivering appropriate patient care and reducing abrasion," notes Cohere ...