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Topic: Prior authorization

Prior authorization is a process where healthcare providers must obtain approval from insurance companies before providing certain medical services or prescriptions in order to receive payment.

More on: Prior authorization

The podcast episodes discuss the growing use of prior authorization by Medicare Advantage plans as a cost-containment tool, and the concerns around inappropriate denials of care through this practice.

In the first episode, Alan Condon discusses a new CMS rule aimed at streamlining and improving transparency around prior authorization requirements. The second episode focuses on the rise of Medicare Advantage plans and the Congressional scrutiny over their use of prior authorization to deny care.

The topic of prior authorization is closely tied to healthcare regulation, costs, and insurance practices, which impact both patients and providers.

All Episodes