Latest updates for Ai-Powered Prior Authorization System

Fresh curated links around AI-powered prior authorization system are collected here so marketers can spot useful updates and turn timely ideas into posts faster.

Recent items include:

  • AI speeds up prior auth, coding while driving higher costs for health systems: PHTI report
  • CMS’s New AI-Powered Prior Authorization System: Will It Speed Up Approvals or Deny Seniors Critical Care?
  • Surescripts Expands Prior Authorization Automation: Slashing Prescription Approval Times as New CMS Interoperability Rul

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fiercehealthcare.com /1 month ago

AI speeds up prior auth, coding while driving higher costs for health systems: PHTI report

AI can allow organizations to execute expedited prior authorizations at reduced costs, but there is no existing evidence it “translates to lower average cost per claim factoring in...

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savingadvice.com /1 week ago

CMS’s New AI-Powered Prior Authorization System: Will It Speed Up Approvals or Deny Seniors Critical Care?

For years, seniors and doctors have complained that prior authorization delays can feel like a second illness layered on top of an existing medical problem....

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hitconsultant.net /1 week ago

Surescripts Expands Prior Authorization Automation: Slashing Prescription Approval Times as New CMS Interoperability Rul...

What You Should Know Surescripts has expanded its Prior Authorization Automation solution, increasing the number of enabled clinicians by 50% since December 2025 to reach 68,000 pr...

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crooksandliars.com /3 weeks ago

UnitedHealth Says They Will Use AI To Reduce Prior Authorizations

UnitedHealth Group plans to stop requiring doctors to get approvals for an array of procedures, tests and services, cutting back on a process detested by physicians and patients. U...

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medcitynews.com /1 month ago

‘Prior Authorization’ Has Become a Dirty Word in Healthcare, But it Might Be Medicare’s Smartest Path Forward

Since its inception, AI in prior auth has only been at work in the commercial healthcare marketplace. Now new innovative approaches that reframe prior auth as a resource instead of...

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histalk2.com /3 weeks ago

Healthcare AI News 5/6/26

News UnitedHealth Group will eliminate prior authorization requirements for 30% ...

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fiercehealthcare.com /1 month ago

Rethinking Prior Authorization for Better Outcomes

Abarca’s Javier Gonzalez explores how trust, tech and policy can transform prior authorization and improve access and efficiency.

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fiercehealthcare.com /1 month ago

AI-powered prior authorizations for Medicare have greatly delayed care, Washington state hospitals say

The Centers for Medicare & Medicaid Services' experimental WISeR Model has Medicare patients waiting two to four times longer for procedures, according to a Washington senators...

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medcitynews.com /1 month ago

Digitizing Medical Policy Alone Will Not Automate Prior Authorization at Scale

Many health plans are discovering that even after digitizing medical policies and implementing FHIR APIs, prior authorization turnaround times remain slow and provider frustration...

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fiercehealthcare.com /1 month ago

How CVS Caremark is using innovative technology to simplify the prior authorization process

A faster, easier prior authorization experience ensures providers can focus on their patients and helps ensure people get their medications quickly

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natlawreview.com /1 month ago

State Legislatures Consider Oversight of Artificial Intelligence in Health Insurance Decisions

As artificial intelligence (“AI”) continues to be deployed in new use cases, state legislatures are considering measures to oversee its use in health insurance, particularly in pri...

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aha.org /3 weeks ago

CMS announces electronic prior authorization initiative

The Centers for Medicare & Medicaid Services yesterday announced a new electronic prior authorization initiative as part of its Health Technology Ecosystem. CMS Administrat...

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fiercehealthcare.com /2 weeks ago

Health systems are exploring AI-powered cardiac risk screening. New CMS reimbursement could unlock a business case for i...

Bunkerhill Health executives offered a deeper look at the process for securing a CMS reimbursement pathway for AI-enabled cardiovascular analysis.

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healthcareittoday.com /1 month ago

Standard AI is a Black Box. Here is Why RAAPID Built a Glass One for Risk Adjustment.

The problem with AI in the revenue cycle is transparency. You simply can't afford to guess how an algorithm arrived at a billing code. Here is how RAAPID is using neuro-symbolic AI...

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fiercehealthcare.com /3 weeks ago

Assort Health rolls out outbound AI agent for personalized patient outreach

Startup Assort Health developed an outbound AI agent that can proactively reach out to patients to automate appointment rescheduling, close open referrals, tackle payment collectio...

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theheartysoul.com /2 weeks ago

UnitedHealthcare Is Dropping Prior Authorization for 30% of Services – Here’s What It Means

Every American who has ever needed surgery, a scan, or a specialist referral knows the particular dread of those three words: “prior authorization required.” It means your doctor h...

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fiercehealthcare.com /1 month ago

Prior authorization: Today’s innovators speak out

Across the session, speakers returned to one idea: the challenge is not prior authorization alone, but the fragmented, manual experience surrounding it. Here’s what they had to say...

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healthcare-economist.com /1 month ago

How are payers and providers using AI? And why isn’t AI reducing administrative cost?

The Peterson Health Technology Institute (PHTI) recently released a report titled: “Administrative AI: Current Use and Potential Impact.” The report was based on a workshop PHTI co...

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aha.org /1 month ago

CMS releases proposed rule establishing electronic standards for drug prior authorizations

The Centers for Medicare & Medicaid Services April 10 released a proposed rule that would establish electronic standards for drug prior authorizations. Building on a 2024 f...

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natlawreview.com /1 month ago

CMS Proposes Major Changes to Drug Prior Authorization Processes: What You Need to Know

On April 14, 2026, the Centers for Medicare and Medicaid Services (“CMS”) published a proposed rule[1] that would require faster prior authorization (“PA”) decisions, expand electr...

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insurancebusinessmag.com /1 month ago

Health insurers reduce prior authorization by 6.5 million

Appeals overturn most denials

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fiercehealthcare.com /1 month ago

Proposed CMS rule would set prior auth deadlines for drugs

The Trump administration has issued a proposed rule that aims to significantly overhaul prior authorization for pharmaceuticals.

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medcitynews.com /1 month ago

The Next Era of Payment Integrity: Earlier Clinical Validation, True Transparency

By using AI-powered intelligence to shift clinical and coding validation earlier in the healthcare continuum, and unlocking upstream clinical data to inform downstream payment work...

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newswire.com /1 month ago

AimwellBio Launches the System That Catches What AI Gets Wrong: Before It Reaches Patients, Boards, or Your Portfolio

AI is making life-or-death decisions in healthcare, and nobody is checking if the answers are real. AimwellBio is the first platform that does. FHIN founding cohort now forming.

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histalk2.com

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hitconsultant.net

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medcitynews.com

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theheartysoul.com

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aha.org

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