between · where
An emergent story thread — signals the timeline clustered together from their own shared language, not a fixed topic.
3 signals in the last 30 days Structural & Policy Drivers
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Prior authorization denials vary widely among insurers, first-of-its-kind data shows
Denials ranged from 2% to 25% among insurers last year, according to a KFF analysis of new prior authorization data that the CMS forced insurers to release.
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Where prior authorization stands — and where data still falls short
Prior authorization data is now public — but it is not giving much to work with. CMS’ Interoperability and Prior Authorization Final Rule from 2024 focused on easing prior authorization across government-affiliated healthcare programs. Involved payers now have to report certain aggregated metrics, such as approval and denial rates. Data covering 2025 went live March […] The post Where prior authorization stands — and where data still falls short appeared first on Becker's Payer Issues | Payer...
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Insurers denied between 12% to 18% of prior authorization requests in 2025: KFF
Researchers analyzed data from insurers in Medicare Advantage, Medicaid managed care and ACA Marketplace market segments—representing approximately 71 million enrollees.