Regulation of AI in Prior Authorization and Claims Review: A Look at Federal and State Consumer Protections
Federal Regulation and Oversight of AI Few federal standards apply specifically to the use of AI in the prior authorization...
Are Health Insurance Companies the Reason for Our Health System’s Ills?
In this JAMA Health Forum column, KFF’s Larry Levitt examines the criticism that health insurance companies are facing from political leaders, and...
Proposed CMS rule would set prior auth deadlines for drugs
The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for pharmaceuticals. Through the Interoperability...
Poll: People View Prior Authorization as Greatest Burden in Navigating the Health System
New KFF polling explores the challenges beyond costs that people with insurance face in navigating the health care system. People...
What are the benefits of automated vs. manual prior authorization software?
At A Glance Automated prior authorization solutions streamline workflows, simplify management across payer systems and offer advanced features to reduce...
New tech company Stellarus expands to more health plans
Stellarus, a Blue Shield of California sister company that was spun out in January, is banding together with two Blues...
Prior authorization has created a perception problem
Clear communication, as part of the doctor-patient relationship, is one of the most fundamental aspects of healthcare delivery. Patients need...
HHS finalizes rule for prescription drug cost transparency
The health IT arm of the Department of Health and Human Services finalized a rule this week that federal leaders...
CMS excludes anti-obesity drug coverage under Medicare, Medicaid
The Centers for Medicare and Medicaid Services (CMS) finalized a Medicare Advantage (MA) rule proposed by the Biden administration, but...
Congress must address doctor shortage and burnout
If you’ve been forced to wait for medical care recently, you’re not alone. In the past year, a third of patients have...
