Medicaid Managed Care Organizations (MCOs) denied one out of eight prior authorization requests in 2019, according to a new report from the Office of Inspector General (OIG). The OIG review included ...

A report by the Office of Inspector General (OIG) finds Medicaid managed care members may not be receiving all medically necessary services. Medicaid managed care organizations (MCOs) denied one out ...

Enrollees in Medicaid plans employing prior authorization policies for opioid medications may have lower rates of opioid medication abuse and overdose. ABSTRACTObjectives: The US opioid medication ...

U.S. Representative Frank Pallone, Jr. (D-New Jersey), Energy and Commerce Committee ranking member, announced Thursday that he is investigating the “high rates” of prior authorization denials by ...

Add Yahoo as a preferred source to see more of our stories on Google. The 2025 session will have few new dollars not swallowed up by Medicaid, limiting options for lawmakers to address health concerns ...

This study examined the impact of prior authorization formularies on the likelihood that patients with schizophrenia will be arrested and incarcerated. We collected drug-level information on prior ...

Forbes contributors publish independent expert analyses and insights. Jesse Pines is an expert in healthcare innovation and wellness. This voice experience is generated by AI. Learn more. This voice ...

The proposed rule could amplify the meaningful progress made by healthcare technology innovators and provide a more ...

Cohere Health®, the leader in clinical intelligence solutions for health plans, today announced its support of the Centers for Medicare and Medicaid Services (CMS) Health Tech Ecosystem initiative and ...

Over the past five years, selective cyclooxygenase-2 inhibitors (coxibs) have accounted for a growing proportion of prescriptions for nonsteroidal antiinflammatory drugs (NSAIDs). To control these ...

UnitedHealthcare is taking a big step to make healthcare access easier.