prior authorization Archives - HIT Leaders and News

Prior Authorization Enters Its Test Phase

Jason Free — Mon, 18 May 2026 10:44:44 +0000

The next phase of prior authorization reform will not be decided by whether healthcare organizations support electronic exchange in principle. That consensus already exists. The real test is whether payers, providers, EHR developers, networks, and digital health companies can make electronic prior authorization work inside the messy conditions of actual care delivery.

The post Prior Authorization Enters Its Test Phase appeared first on HIT Leaders and News.

Prior Authorization Reform Becomes an Execution Test

Jason Free — Mon, 11 May 2026 11:35:05 +0000

Prior authorization reform has moved from a policy debate to an operational stress test. The central issue is no longer whether fax-driven approval workflows are inefficient. That case has been made repeatedly by physicians, patients, regulators, and payers themselves.

The post Prior Authorization Reform Becomes an Execution Test appeared first on HIT Leaders and News.

Prior Authorization Enters Its Infrastructure Era

Jason Free — Tue, 14 Apr 2026 12:32:07 +0000

The Centers for Medicare & Medicaid Services is using its 2026 proposed rule on interoperability and drug prior authorization to do more than shorten approval timelines.

The post Prior Authorization Enters Its Infrastructure Era appeared first on HIT Leaders and News.

The CMS Rule That Finally Targets the Paperwork Nobody Fixed

Jason Free — Mon, 23 Mar 2026 11:47:44 +0000

The latest move from the Centers for Medicare & Medicaid Services will be easy to underestimate because it sounds so administrative. The newly finalized health care claims attachments rule deals with documentation, transaction standards, and electronic signatures, not a flashy care model or a breakthrough therapy. Yet it may prove to be one of the more important healthcare modernization actions in years precisely because it aims at a part of the system that has remained stubbornly primitive long after the industry declared itself digital.

The post The CMS Rule That Finally Targets the Paperwork Nobody Fixed appeared first on HIT Leaders and News.

Availity, Concert Partner to Digitize and Automate Prior Authorization for Genetic Testing

Jason Free — Fri, 10 Jan 2025 20:33:08 +0000

Availity, the nation’s leading real-time health information network, and Concert, the leading provider of clinical content and payment accuracy solutions for advanced diagnostics, have partnered to digitize and automate the prior authorization and payment processes for genetic tests.

The post Availity, Concert Partner to Digitize and Automate Prior Authorization for Genetic Testing appeared first on HIT Leaders and News.

Blue Shield of California, Salesforce Making Prior Authorization as Simple as Using a Credit Card

Jason Free — Fri, 25 Oct 2024 11:08:02 +0000

Blue Shield of California and Salesforce are teaming up to solve a significant healthcare challenge — providing physicians and their patients prior authorization answers in near real-time, rather than days.

The post Blue Shield of California, Salesforce Making Prior Authorization as Simple as Using a Credit Card appeared first on HIT Leaders and News.

AMA: We Must Fix Prior Authorization to Protect our Patients

Jason Free — Mon, 24 Jun 2024 12:51:03 +0000

Across the country, physicians see firsthand the dangerous, harmful—and sometimes deadly—consequences of prior authorization.

The post AMA: We Must Fix Prior Authorization to Protect our Patients appeared first on HIT Leaders and News.

Prior Authorization Platform Humata Health Closes $25M Investment

Jason Free — Mon, 24 Jun 2024 12:47:55 +0000

Humata Health, the company creating prior authorizations for payers and providers with AI and automation, announced that it closed a $25 million investment.

The post Prior Authorization Platform Humata Health Closes $25M Investment appeared first on HIT Leaders and News.

Cohere Health Raises $50 Million in Equity to Meet Increased Demand for AI-Driven Transformation of Prior Authorization Process

Jason Free — Mon, 05 Feb 2024 14:38:36 +0000

Cohere Health, a recognized leader in clinical intelligence and prior authorization automation, announced it has closed $50 million in additional equity funding.

The post Cohere Health Raises $50 Million in Equity to Meet Increased Demand for AI-Driven Transformation of Prior Authorization Process appeared first on HIT Leaders and News.

CMS Interoperability and Prior Authorization Final Rule CMS-0057-F

Jason Free — Thu, 18 Jan 2024 13:04:06 +0000

The Centers for Medicare & Medicaid Services (CMS) affirms its commitment to advancing interoperability and improving prior authorization processes with the publication of the CMS Interoperability and Prior Authorization final rule (CMS-0057-F).

The post CMS Interoperability and Prior Authorization Final Rule CMS-0057-F appeared first on HIT Leaders and News.