Topic: Prior Authorization
Having to seek prior authorization from payers is the most burdensome regulatory issue, and it’s only getting worse, according to practice leaders.
Even the highest-performing physicians and practices will see a “piddly” payment adjustment under the Merit-based Incentive Payment System.
Employers are looking to change the location for administering specialty drugs as one of the strategies to rein in high drug prices, a survey found.
HL7 and CAQH CORE are collaborating to move the industry toward end-to-end automation of the prior authorization process.
As Congress takes a close look at prior authorization, payer groups are defending the practice, which they say is a crucial tool to control costs.
Hundreds of healthcare groups urged Congress to pass a bill to reform the prior authorization process for Medicare Advantage patients.
Emergency physicians see their share of patients who end up in trouble because of opioid use, but encounter obstacles to providing optimal care.
Payers have made strides digitizing and automating many core processes, yet prior authorization remains a largely manual, cumbersome process.
Specialty drugs made up 1% of prescriptions for employers but accounted for 40% of total drug spending last year, an analysis found.
Medicare could save nearly $3 million a year if it adopted a stricter approach to price substitution in Part B, watchdog finds.