There is a tendency to overlook the multiple factors and stakeholders that contributed to the Rx opioid crisis. This includes ...

Still, gross spending on the drugs increased by more than 500% from 2019 to 2023, according to the health policy research ...

Survey reveals 86% of physicians frustrated with prior authorizations hindering patient care. Find out the common challenges and desired changes in the process ...

The most familiar example is prior authorization, a process through ... federal and state governments that cover care through Medicaid and Medicare Advantage, and insurers. Another scenario ...

released a final rule implementing changes to the Medicaid Drug Rebate Program (MDRP). While not the focus of the agency’s rulemaking, stakeholders used the opportunity to comment on the ...

Our Medicare Advantage prior authorization protocols are routinely audited by the Centers for Medicare & Medicaid Services and we recently received a perfect score on an audit examining compliance ...

The three largest Medicare Advantage insurers have dramatically increased prior authorization requirements ... criteria the Centers for Medicare and Medicaid Services set, "demanding greater ...

Opens in a new tab or window Medicare Advantage plans have increased their use of prior authorization and appear to be targeting certain types of care -- such as expensive post-acute hospital care ...

Medicaid waiver programs may allow you to get long-term medical care at home or in a community facility. Medicare usually limits the amount of these services you can receive. If you or a loved one ...

Blue Cross Blue Shield is the best insurance company for weight loss drug coverage because sometimes ... This is called prior authorization, and it means your doctor will need to submit a form to your ...

When the one pharmacy in town closed in Antwerp ... for independent pharmacies that are in areas with a high number of Medicaid and Medicare patients because, in general, they are reimbursed ...