Topic: Prior Authorization
Humana is launching new initiatives aimed at easing the administrative burden on providers as they treat patients with COVID-19.
Government insurer Oscar Health will cap the price of roughly 100 drugs, including insulin, at only $3 for about half of its members.
PBM tools such as rebates can help reduce drug costs for plans by nearly $1 trillion over the next decade, a PBM industry report said.
The head of the American Medical Association warned automating prior authorization requests isn't the final solution to problems plaguing providers.
An oncologist group is pressing Congress to pass a 72-hour deadline for pharmacies, PBMs and insurers to approve and fill cancer drug prescriptions.
CAQH CORE has voted to set a two-day time limit on how quickly health plans must act on prior authorizations.
In Texas, 25% of patients say insurers have refused to cover a medicine, procedure, test or scan that a doctor ordered for them or a family member.
A commonly used format for formulary submissions has been updated to enable drug companies to share information with payers on unapproved products.
In a recent survey, 84% of providers reported the number of medical services that require prior authorization has increased.
The cost of prior authorization requirements on physician practices has continued to increase—up 60% in 2019 to manually generate a request.