Understanding the Medicare Prior Authorization Pilot Program: What to Expect Starting January 1, 2026
Introduction to the Pilot Program The Medicare Prior Authorization Pilot Program is an important initiative set to launch on January 1, 2026, across six selected states. This program is designed to streamline the approval processes for specific healthcare services, enhancing the overall efficiency of patient care delivery. The primary objective is to...
Understanding Prior Approval in Medicare: Key Changes and Implications for 2025-2026
What is Prior Approval in Medicare? Prior approval, commonly referred to as prior authorization, is a pivotal process within the Medicare system aimed at managing healthcare services, procedures, and prescriptions. This mechanism requires healthcare providers to obtain explicit approval from Medicare or Medicare Advantage plans before delivering specific medical interventions. By enforcing...
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