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Study examines increase in states banning prior authorization in private health plans for OUD medications

A Health Affairs study published Nov. 3 examined an increase in states banning prior authorizations in private insurance plans for opioid use disorder medications.
Prior Authorization, Opioid Use Disorder

AHA shares concerns, recommendations with CMS on WISeR model

The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address multiple concerns.
Prior Authorization, Artificial Intelligence (AI), Medicare Advantage
Public

AHA Comments on CMS WISeR Model

October 23, 2025
Prior Authorization

Breaking the Claims Denials Cycle

Prevent costly denials with AI-driven front-end tech and CDI tools to catch errors early and apply real-time payer strategies to boost outcomes.
Prior Authorization, Payer Relations, Access & Health Coverage, Quality & Patient Safety, Artificial Intelligence (AI), Leveraging Technology

AHA provides recommendations to HHS, CMS for insurers to adhere to prior authorization pledge 

The AHA Sept. 29 sent recommendations to the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to help ensure insurance plans adhere to the agencies’ health insurer pledge to reform prior authorization processes.
Prior Authorization, Medicare Advantage, Health Insurance
Public

AHA Supports Administration Facilitating Health Insurer Pledge to Reform Prior Authorization

AHA supports the Administrations role in facilitating the health insurer pledge to reform prior authorization processes announced on June 23.
Prior Authorization, Health Insurance, Commercial Insurer Accountability

CMS Innovation Center releases FAQ on prior authorization program pilot

The Centers for Medicare & Medicaid Services Innovation Center Aug. 12 released an FAQ on the Wasteful and Inappropriate Service Reduction Model, a six-year technology-enabled prior authorization program pilot.
Prior Authorization, Innovation/New Models of Care
Member

Regulatory Advisory: Health Data, Technology and Interoperability (HTI-4) FY 2026 Final Rule

The Centers for Medicare & Medicaid Services (CMS) July 31 issued its hospital inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS final rule for fiscal year (FY) 2026.
Interoperability, Data, Prior Authorization, Technology
Public

AHA Comments on the CMS and ASTP/ONC Request for Information Re: The Health Technology Ecosystem

AHA comments on the Centers for Medicare & Medicaid Services and Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology Request for Information regarding the Health Technology Ecosystem.
Interoperability, Technology, Prior Authorization

CMS announces new prior authorization program pilot

The Centers for Medicare & Medicaid Services June 27 announced the rollout of a 6-year technology-enabled prior authorization program pilot.
Leveraging Technology, Technology, Innovation/New Models of Care, Access to Behavioral Health, Community Partnerships, Prior Authorization, Advocacy & Public Policy