Health Insurance News States Target Health Insurers’ ‘prior Authorization’ Red Tape

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 in practice, it often means delayed appointments, stalled medication ... Read More

One woman’s tick bite sets off fight over insurance and prior authorization

Leah Kovitch was pulling invasive plants in the meadow near her home one weekend in late April when a tick latched onto her leg. She did not notice the tiny bug until Monday, when her calf muscle ... Read More

NCOIL adopts model law to overhaul prior authorization practices

The National Council of Insurance Legislators (NCOIL) has adopted the Prior Authorization Reform Model Act at its 2025 Annual National Meeting in Atlanta, Georgia. The Model, sponsored by Mississippi ... Read More

Medicare is of two minds on prior authorization

As the year comes to a close, the Trump administration seems to be going in two different directions when it comes to the use of prior authorization in Medicare. On the one hand, there is the effort ... Read More

As CMS grapples with prior authorization, states step into the void

At least 18 states took action on health insurers’ use of prior authorization this year, a sign that lawmakers aren’t content to wait on federal regulators to step in on a key consumer and provider ... Read More

Patients deploy AI bots to battle health insurers that deny care using similar technology

As states strive to curb health insurers' use of artificial intelligence, patients and doctors are arming themselves with AI tools to fight claims denials, prior authorizations and soaring medical ... Read More

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 ... Read More

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 ... Read More

AI vs. AI: Patients deploy bots to battle health insurers that deny care

As states strive to curb health insurers' use of artificial intelligence, patients and doctors are arming themselves with AI tools to fight claims denials, prior authorizations and soaring medical ... Read More