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Prior Authorization

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February 29, 2024
3 min read
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Insurers reject PCSK9 inhibitors at a higher rate vs. other cardiometabolic prescriptions

Insurers reject PCSK9 inhibitors at a higher rate vs. other cardiometabolic prescriptions

PCSK9 inhibitors are rejected by insurance providers at a higher rate compared with other guideline-indicated cardiometabolic drugs despite expanded labeling and reduced manufacturer cost, researchers reported.

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February 20, 2024
8 min read
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Rule streamlining prior authorization is a step forward for primary care, 'but not a leap'

Rule streamlining prior authorization is a step forward for primary care, 'but not a leap'

The new CMS rule aiming to streamline prior authorization signals a major step forward for primary care, but the process could still use some improvement, according to experts.

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February 05, 2024
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Study of prior authorization’s impact on cancer treatment reveals ‘signal of danger’

Study of prior authorization’s impact on cancer treatment reveals ‘signal of danger’

More than one in five people with cancer did not receive clinician-recommended care due to prior authorization requirements, according to study results.

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January 31, 2024
2 min read
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Insurance-mandated barriers linked to negative clinical outcomes in IBD care

Insurance-mandated barriers linked to negative clinical outcomes in IBD care

LAS VEGAS — Medication denials, forced medication switches and prior authorizations were among insurance-mandated barriers associated with negative clinical outcomes among patients with inflammatory bowel disease, according to data.

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January 17, 2024
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CMS finalizes rule streamlining, digitizing prior authorization process

CMS finalizes rule streamlining, digitizing prior authorization process

CMS has finalized a new final rule that aims to shorten prior authorization timelines and streamline processes to remove barriers to patient care, according to a press release.

News
December 27, 2023
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Top 10 in 2023: Women in Oncology’s most-read stories of the year

Top 10 in 2023: Women in Oncology’s most-read stories of the year

Women in oncology continued to break barriers, unveil new research and accomplish goals in 2023.

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November 21, 2023
1 min read
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Prior authorization to approve TJA may increase surgical wait times, administrative burden

Prior authorization to approve TJA may increase surgical wait times, administrative burden

GRAPEVINE, Texas — Prior authorization to approve elective total joint replacement may increase surgical wait times and lead to a high administrative burden, according to results presented here.

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October 07, 2023
2 min watch
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VIDEO: 'AI offers world-changing ability' to improve primary care practices

VIDEO: 'AI offers world-changing ability' to improve primary care practices

ORLANDO — Primary care physicians can use large language model artificial intelligence to substantially improve their practices, according to a presenter at OMED.

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August 03, 2023
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‘Nobody understands what is going on’: Knowledge key to navigating prior authorization

‘Nobody understands what is going on’: Knowledge key to navigating prior authorization

AUSTIN, Texas — Understanding the laws governing prior authorization is one way rheumatology professionals can ensure patients receive the drugs they need on time, a presenter said at the 2023 Rheumatology Nurses Society annual conference.

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July 17, 2023
3 min read
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AI enhances patient, clinician experience

AI enhances patient, clinician experience

Medical coding historically has been a manual and disjointed process, with office managers, coding specialists or clinicians reviewing the data after patient visits and coding to the best of their abilities.

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