The Centers for Medicare and Medicaid Services ... may relax prior authorization requirements for federally regulated plans in states with stricter laws for other forms of insurance so their ...

Prior authorization is a key tool for ensuring high-quality patient care, but it needs to be refined, Humana CEO Jim Rechtin ...

Physicians frequently cite prior authorization requirements as a significant source of administrative burden. Now, ...

States are not required to provide prescription drug coverage under their Medicaid programs, although all states do provide some form of coverage ... must receive prior authorization before ...

Off-label prescribing is when a medication is prescribed for a purpose not approved by the FDA. Insurance might cover off-label prescriptions, but it depends on the specific plan and often requires a ...

Gold carding eliminates prior authorization for top-performing labs and eases plan workflows while controlling spending and ...

The report said about 2.8 million Pennsylvania residents participate in the Physical HealthChoices program for Medicaid, in which managed care organizations contract with pharmacy benefit managers.

Contraindicated drug pairs are uncommon in youth with Medicaid coverage filling combinations of behavioral and mental health (BMH) medications.

The AHA Sept. 17 urged the Department of Health and Human Services’ Office of Inspector General to further scrutinize ...

EXCLUSIVE: The top Republican on the Senate Budget Committee is demanding answers from both the Newsom and Biden administrations regarding promised repayment of $52 million in "improperly claimed ...

Bayer AG’s kidney drug Kerendia helped patients avoid complications from a common form of heart failure in a study, a boost for the company’s pharma division as it looks to overcome multiple ...

Ozempic (semaglutide) is a brand-name drug that helps manage blood sugar levels and lowers the risk of cardiovascular problems in some people. Ozempic is a solution given as a subcutaneous injection.