Below is a roundup of payer-centric news headlines you may have missed during the month of June 2025. | In June, Gold Coast ...

Optum Rx is nixing reauthorization requirements for more than 60 additional medications. | The PBM giant's list of drugs ...

The model will leverage AI and machine learning for prior authorization of services vulnerable to fraud or inappropriate use, CMS says.

An Orange County man and two other suspects have been charged with carrying out a nearly $270 million Medi-Cal fraudulent ...

Health insurers covering more than 250 million Americans have unveiled a sweeping plan to streamline and reduce prior authorization requirements — a long-standing source of frustration and burnout for ...

Home care providers are monitoring a new Centers for Medicare & Medicaid Services Innovation Center model that will add prior ...

About 1 in 6 insured adults in the U.S. say they’ve had trouble with prior authorizations, according to a recent survey from health policy group KFF.

Ted Okon, MBA, of the Community Oncology Alliance discusses how community oncology faces a revenue crisis due to the ...

Health insurance companies have pledged to improve prior authorization with 6 key reforms, according to the HHS.

An Orange County man is expected to be arraigned July 17 for his alleged role in a health-care fraud scheme in which nearly $270 million in bogus claims were submitted to Medi-Cal for expensive ...

Some fee-for-service spine procedures in traditional Medicare will have prior authorizations added, according to CMS’ new Wasteful and Inappropriate Service Reduction model. CMS is partnering with AI ...